Job description

Job Summary:
Prepares and submits commercial insurance and workman’s comp claims (primary and secondary) in a timely manner, responds to all correspondence, works follow up in a timely manner, communicates with external and internal contacts on a daily basis. Serves as back up for Admissions Clerk. Participates in performance improvement activities. Committed to excellence through the continuous improvement of the quality of services delivered. Strives to continuously improve patient and employee satisfaction.

Job Description:
Running and working the billing reports, preparing Commercial Insurance and Worker’s Compensation claims for submission (primary and secondary)
Reviewing insurance claims for accuracy before mailing or electronic insurance submission, including proper coding and verification of Insurance Company addresses, etc…(CLEAN CLAIMS process)
Follow-up process (Aging Reports, Billed but Unpaid Reports, Buckets)
Correspondence Process (Explanation of Benefits, Letters to Patients and Insurance Companies, including third party claims, etc…)
Verifies with employers and other entities on Worker’s Compensation for billing claims
Verifies insurance coverage for secondary billing
Responds to questions from insurance companies, patients and patients families, and other HRMC departments regarding billing
Scans EOB’s/checks daily
Stays well informed of all Commercial Insurance Bulletins, Advisories, and/or Newsletters
Attend periodic workshops/seminars to learn changes, new billing requirements, etc for Commercial/Worker’s Comp Insurance
Identifies location of fire alarms and fire extinguishers in area
Practices Time Management
Identifies location of fire alarms and fire extinguishers in area
Knows appropriate response to codes
Able to locate MSDS
Demonstrates understanding of policies on ethics
Trains other employees
Able to locate and describe appropriate policies
Understands and is familiar with basic office equipment

Regulatory Requirements:
High School graduate or equivalent.
Insurance billing required.

Language Skills:
Able to communicate effectively in English, both verbally and in writing.
Additional languages preferred.
Excellent customer services skills.
Skills:
Basic computer knowledge.

Job Type: Full-time

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