Insurance Representative

CAROLINA ASTHMA AND ALLERGY CENTER MASTER • Charlotte, NC

11d • Onsite

About The Position

A non-exempt position responsible for the proper and timely processing of claims and payments to providers.

Requirements

• High school diploma or equivalent.
• Minimum two years of experience working insurance AR follow up and claims processing in a health care setting; including denials and appeals.
• Knowledge of clinic policies and procedures.
• Knowledge of health care insurance claim practices and compliance.
• Knowledge of computer systems, programs, and applications.
• Knowledge of medical terminology.
• Skill in gathering and reporting claim information.
• Skill in trouble-shooting claim insurance problems.
• Skill in written and verbal communication and customer relations.
• Ability to work effectively with physicians, other medical staff, and external agencies.
• Ability to identify and analyze claim problems.

Responsibilities

• Weekly review of claim edits reports and corrects the claim information such as (CPTs, valid ICD-10's, referring doctor name/UPIN #, modifiers, etc.).
• Work and corrects claim rejections from Waystar, correcting necessary data.
• Daily follow-up of aged accounts and denied charges.
• Keep A/R Supervisor informed on all Payer problems.
• Contacting insurance carriers via phone or website.
• Handle patient and provider calls in reference to claims or statements.
• Answer and forward incoming calls in a timely manner.
• Identifies and resolves patient billing complaints.
• Performs various collection actions including contacting patients by phone, correcting, and resubmitting claims to third party payers.
• Identify and correct posting errors and overpayments.
• Review and correct COB errors.
• Other duties and projects as assigned.
• Occasional overtime may be required.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED