What are the responsibilities and job description for the Insurance Claims Representative position at Sidney Regional Medical Center?
Sidney Regional Medical Center is searching for an Insurance Claims Representative to join our team. This is a full-time Monday through Friday 8:00am-5:00pm opportunity.
Job Responsibilities:
- Provide excellent customer service
- Follow up with insurance companies on outstanding billed claims.
- Research and correct claim as needed to ensure proper payment.
- Process rejected claims and resubmit for payment.
- Review, correct and resubmit any errors on claims not accepted into the adjudication system
- Review and reconcile all insurance credit balances
- Keeping current on all daily correspondence from payers.
- Identify and initiate any necessary appeals on claims.
- Identify potential account adjustments in accordance to established processes.
- Contact customer in regards to request for additional insurance information that may be needed for processing claims as requested by insurance companies.
- Remain current on insurance billing regulations and compliance issues and responsible for updating processes accordingly.
- Responsible for reviewing all payer newsletters and keeping up to date on policies.
- Run and work numerous aging accounts.
- Understand the importance of accounts receivable numbers and maintain standards set for each payer.
- Employee is expected to be sufficiently knowledgeable about the legal aspects of his or her responsibilities and activities to be able to avoid inadvertent violation of State and Federal statutes and regulations & standards and refrain from knowingly participating in illegal activities or failing to meet affirmative legal duties. Employee shall report any suspected or known illegal activity.
- Employee is required to report any suspected or known illegal activity.
- Regular attendance.
- Other duties as assigned.
Education & Experience:
- High School Diploma or GED
- 2-3 years of healthcare billing experience preferred
Knowledge, Skills, & Abilities:
- Reliable and timely attendance
- Strong customer service skills
- Ability to multi-task and prioritize workload
- Strong team player
- Ability to keep information confidential and protect patient information
Sidney Regional Medical Center is an EEO Employer/Vet/Disabled
