Insurance Representative
Job Summary
The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement. Must understand and be able to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Proactively identifies and performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials. Uses advanced knowledge and understanding to process payer rejections. Conducts trend analyses, appeals and resolves low payment or underpaid accounts. Provides input for payer-specific meetings. Handles difficult account situations and resolves issues delaying or preventing payments from payers.
Qualifications
- High school diploma or equivalent preferred
- Six Months' Related Work Experience Required
- Computer Skills Essential
Benefits
Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits.
Company Information
Sanford Health is the largest rural health system in the United States and is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. Benefits: EEO/AA Employer M/F/Disability/Vet. Drug Free Workplace. Req Number: R-0264684. Job Function: Revenue Cycle. Featured: No.