What are the responsibilities and job description for the Insurance Processor position at Ponca City Development Authority?
KAW NATION POSITION DESCRIPTION
TITLE: INSURANCE PROCESSOR
IMMEDIATE SUPERVISOR: HEALTH DIRECTOR
CONTROLLING SUPERVISOR: Chair
STATUS: Regular, full-time
LOCATION: Newkirk, OK
QUALIFICATIONS:
Requires a High School Diploma or GED with a minimum of 2 years experience in a clinical/physician office setting. Work history should reflect knowledge of medical terminology, ICD-9, ICD-10, CPT coding, and third-party billing. Familiarity with EOBs, ERA posting, and claim follow-up processes. Must be proficient in computer skills including Microsoft Word and Excel. Must have excellent attention to detail, communication, and problem-solving skills. Must have a valid driver license and be insurable.
RESPONSIBILITIES AND DUTIES:
- Post insurance payments via EOB or ERA, adjustments, and refunds with accuracy and timeliness.
- Maintain account reconciliation log.
- Review and correct claim denials and rejections, resubmit claims as needed.
- Conduct regular follow-up on aged and unpaid claims to ensure timely resolution.
- Communicates with insurance companies to verify claim status, resolve discrepancies, appeal denials, and covered benefits.
- Maintain compliance with HIPAA and payer regulations.
- Prepare, submit, and track secondary/tertiary claims.
- Ensures accurate and timely reimbursement for services rendered.
- Performs other duties, consistent with the position, as required or assigned by the immediate supervisor or controlling supervisor.
All new hires will be required by the Kaw Nation to submit to a pre-employment drug screen. Failure to pass the pre hire drug screen will lead to withdrawal of the job offer or termination of employment. All new hires must be able to stand, walk, stoop, bend, kneel, pull, push and lift a minimum of 25 lbs.