What are the responsibilities and job description for the INSURANCE REPRESENTATIVE position at Mississippi Sports Medicine?
INSURANCE REPRESENTATIVE
CHARACTERISTICS OF WORK:
This is professional/clerical work involving the submission, collection, and follow-up of patient insurance claims. Work includes customer service with patients, insurance companies, as well as other outside entities, and assisting with claims resolution.
MINIMUM QUALIFICATIONS:
- Computer skills
- Phone etiquette
- Interpersonal skills
- Insurance claims experience
- Insurance claims reporting
- Hospital and/or medical facility setting work experience
ESSENTIAL FUNCTIONS:
- Follow-up on all outstanding insurance accounts within a timely manner.
- Research denials/underpayments/rejections and requests/inquiries from insurance payers within standard billing cycle timeframe.
- Submit corrected claims and process all claim appeals.
- Ensure appropriate supporting documentation is received and complete to ensure accurate and timely processing of claims.
- Research and perform all secondary billing.
- Possess full understanding of EOBs to ensure payment accuracy and compliance with contract discount.
- Review and recommend claims for adjustment/write off to management.
- Communicate with payers about re-filing claims that were underpaid due to plan/provider errors. Use tracking system to follow up on re-filed claims with plans to ensure complete resolution.
- Researching insurance credits and insurance refund requests
- Other duties as assigned and directed by team management.
EXPERIENCE / EDUCATIONAL REQUIREMENTS:
Education:
Graduate of four-year high school or equivalent (GED).
Experience:
One year experience related to the described duties.
