What are the responsibilities and job description for the Insurance Representative position at Carolina Asthma And Allergy Center?
General Summary: A nonexempt position responsible for the proper and timely processing of claims and payments to providers.
Essential Job 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.
Education: High school diploma or equivalent.
Experience: Minimum two years of experience working insurance AR follow up and claims processing in a health care setting; including denials and appeals.
