Insurance Claim Representative

Job Overview
We are seeking a dedicated and detail-oriented Insurance Claim Representative to join our dynamic team. Responsible for ensuring timely filing of claims for insurance classes, maintaining current accounts on aging reports for designated insurance classes, processing remittances for the different insurance classes, posting payments and adjustments onto the patient's account. Performing other billing office functions as outlined in billing procedures and as requested by the Practice Administrator. The ideal candidate will possess a strong understanding of medical coding, billing, and claims processing, with the ability to evaluate and resolve insurance claims efficiently. Your expertise will contribute to maintaining high standards of service and compliance within our organization.

Responsibilities

• Reviews and edits insurance claim forms and related documents for completeness.
• Corrects incomplete insurance claim information by researching patient charts or contacting patients and updating the computer database when appropriate.
• Submits claim forms to the proper insurance company within 48 working hours.
• Completes all written correspondence and/or forms from insurance companies and telephone inquiries from patients in a timely manner.
• Answers patient questions regarding insurance or payment options.
• Processes remittance advice for payment/adjustment posting received from insurance companies and/or patients and posts amounts to the patient’s account.
• Audits and corrects billing deficiencies as necessary and contacts insurance companies.
• Provides daily balancing from responsible insurance companies/patients.
• Strong understanding of medical terminology, medical records management, and healthcare documentation practices.
• Experience with medical billing processes and medical collection procedures.
• Familiarity with EMR systems and EHR platforms for efficient data management.
• Knowledge of insurance policies, claim adjudication processes, and regulatory compliance requirements.
• Excellent analytical skills with attention to detail for reviewing complex claims data.
• Effective communication skills for collaborating with healthcare providers, insurance representatives, and patients. Join our team as an Insurance Claim Representative to play a vital role in ensuring accurate claims processing while supporting our commitment to exceptional healthcare service delivery!

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Paid time off
• Vision insurance

Work Location: In person