What are the responsibilities and job description for the Claims and Accounts Representative position at Okeene Municipal Hospital?
Job Overview
We are seeking a detail-oriented and knowledgeable Claims and Accounts Representative to join our team. This role is essential in managing and processing claims and payments efficiently while ensuring compliance with relevant laws and regulations. The ideal candidate will possess a strong understanding of medical records, and insurance processes. You will be responsible for reviewing claims, verifying information, and communicating with various stakeholders to facilitate timely resolutions. As needed, provides administrative support for other staff.
Duties
- Review and process claims for accuracy and completeness in accordance with company policies and procedures.
- Verify insurance coverage and eligibility through effective insurance verification techniques.
- Utilize software to manage claim data and maintain accurate records.
- Communicate with healthcare providers, policyholders, and internal departments regarding claim status and required documentation.
- Ensure proper coding of claims using ICD-10 and DRG standards to facilitate appropriate processing.
- Maintain organized files for all claims processed, ensuring easy retrieval of information when needed.
- Assist in resolving disputes or discrepancies related to claims by conducting thorough investigations.
- Works accounts sent to Bad Debt collections.
- Provides help at front desk as needed – customer service, patient, and physician related tasks.
Qualifications
- Familiarity with medical terminology, medical records, and the insurance verification process is essential.
- Proficiency in clerical tasks including data entry, filing, and documentation management.
- Experience with using telephone, fax, and email systems.
- Excellent communication skills, both written and verbal, to interact professionally with clients and team members.
- Strong analytical skills with attention to detail to ensure accuracy in claim processing.
- Ability to work independently as well as collaboratively within a team environment.
Job Type: Full-time
Pay: $17.86 - $22.80 per hour
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: In person
Salary : $18 - $23