Insurance (Claims) Followu-up Representative

Description

Job Purpose: Responsible for all insurance (claims) follow-up on assigned accounts from the management team.

JOB FUNCTIONS:

Essential Duties & Responsibilities

•  Perform various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers, verifying insurance, charge payments and refund posting as well as coding reviews and audits.
• Research, insurance billing and adjustment identification to ensure proper account resolution.
• Prepare and submit clean claims to various insurance companies either electronically or by paper.
• Follow up and report status of delinquent accounts.
• Answers questions from patients, clerical staff and insurance companies.
• Maintain strict confidentiality; adhere to all HIPAA guidelines/regulations.
• Conducts self in accordance with GU's employee manual.
• Other duties as assigned.

Requirements

QUALIFICATIONS:

Knowledge

Education/Training

•         High School Diploma or GED.

Skills & Abilities:

• Knowledge of medical billing/collection practices.
• Knowledge of insurance companies policies & procedures, including Government plans
• Knowledge of business office procedures.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Ability to operate a multi-line telephone system.
• Skill in answering a telephone in a pleasant and helpful manner.
• Ability to read, understand and follow oral and written instructions.
• Knowledge of billing practices, ie. FIN Class, commercial payers, NaviCare, etc.
• Must be well organized and detail-oriented.

Computer literacy:

• Ability to operate a computer and basic office equipment.
•  Knowledge of computer programs.

Certificates/LIcenses/Registrations

•  NA.

Driving Requirements:

•  N/A.

SPECIAL REQUIREMENTS:

Physical Demands: Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a calculator and computer keyboard.

This description is intended to provide only basic guidelines for meeting job requirements.

Responsibilities, skills and working conditions may change as needs evolve and are assigned by the supervisor.

Work Environment: Normal office environment, Occasional overtime may be required and/or hours may be shortened according to business needs.

DISCLAIMER: This job description is not intended to be all-inclusive; therefore, management has the right to assign or reassign schedules, duties and responsibilities to this job at any time, as business requirements dictate. It is mutually agreed that this job description does not constitute a written or implied contract of employment.

Georgia Urology is an EOE and provides a Drug Free Workplace