Medical Insurance Claims Representative

Job Summary

The Medical Insurance Claims Representative contributes to the company's mission, vision, and values by completing follow-up and collections for patient services. This role involves obtaining payment from third-party payers and self-pay accounts, monitoring insurance claims, and negotiating payment plans.

Qualifications

• Minimum (1) year of experience in a medical office setting, preferably in an ambulatory surgery center, hospital, or doctor’s office.
• Preferred knowledge of managed care payers and medical terminology.

Responsibilities

• Perform follow-up activities on accounts to ensure prompt payment.
• Identify and correct coding or billing errors from EOBs.
• Contact insurance companies to resolve claims.
• Update patient account records to reflect actions taken.
• Assign bad debt accounts to the collection agency.
• Act as a liaison and administer contracts for collection of third-party accounts (Medicare and Medicaid).
• Complete account reconciliation of accounts turned over to outside agencies.
• Negotiate payment plans on self-pay accounts.
• Maintain accounts receivable and reduce bad debt.

Benefits

• Comprehensive benefits including medical, prescription drug, dental, vision, behavioral health, and telemedicine services.
• Wellbeing support such as free counseling and referral services.
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• Savings and retirement resources including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, and flexible spending accounts.
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection, and consumer discounts.