Unpaid Claims Representative

Responsibilities

• Follow up on unpaid insurance claims for assigned payers to ensure timely resolution.
• Investigate each denied or rejected claim thoroughly and determine the necessary corrective actions.
• Resubmit or appeal claims as needed to secure proper reimbursement.
• Communicate directly with insurance companies to gather information, clarify denials, and resolve issues.
• Respond promptly to inquiries from Providers, Patient Financial Services, and the Insurance Team.
• Maintain a strong understanding of insurance guidelines, billing rules, and interpretation of EOBs.
• Identify recurring issues or trends with specific insurance companies and escalate as appropriate.
• Perform additional duties as assigned by management to support departmental operations.

Requirements

• At least 6+ months of experience in the Sagent Behavioral Health's Business Office or comparable claims/AR experience.
• Familiarity with insurance company guidelines, billing procedures, and claim adjudication processes.
• Strong attention to detail, problem-solving skills, and a positive, team-oriented mindset.
• Proficiency with Microsoft Windows, Excel, Word, and Outlook.
• A high school diploma or equivalent, with strong organizational and multitasking abilities.

Pay

$20.00-$22.00/hr. Actual compensation may be determined by various factors such as education, experience, skillset, internal equity, schedule and/or location.

Schedule

Monday through Friday 7:00 AM - 3:30 PM