Medical Insurance Claims Representative

Full Job Description

The Medical Insurance Claims Representative position will be responsible for reviewing claims and following up with insurance companies and patients to ensure payment is received for all physical therapy services provided. Additionally, Medical Insurance Claims Representative will assist in reviewing EOBs and posting insurance payments in order to ensure the proper collection for services provided. 

Job Responsibilities

 Responsibilities of the Medical Insurance Claims Representative include:

·      Follow up on all accounts regularly to ensure that claims are being paid by the insurance carrier on time and according to our contract reimbursement

·      Claims denied for authorization or benefit limitations are retro authorized or appealed

·      Insurance updates regarding reimbursement or regulations are communicated to the Account Manager to increase, or maintain, max reimbursement and to reduce confusion regarding patient benefit coverage

·      Patient billing questions, upsets and complaints are quickly handled with a positive outcome

·      Accounts regularly audited to ensure proper billing, payments and to correct any posting errors and account status to ensure claims are accurately billed and paid by the responsible party

·      All ERAs and EOBs are accurately posted daily

·      All services billed for maximum reimbursement

Job Requirements

We are looking for an organized and highly detail-oriented candidate with insurance claims experience in the medical field. The candidate must enjoy helping others, as this is the main focus of our business. Candidate must also have the following qualifications:

·      Experience in medical insurance claims management

·      High attention to detail

·      Ability to meet strict deadlines and production quotas

·      Ability to learn quickly and apply that knowledge

·      Have the ability to think and respond quickly, be persistent, and have good control of conversations over the phone

·      Strong computer skills

·      Willingness to work as a team player

·      Good organizational skills

·      Fast-speed internet & two computer monitors 

Skills Required

• Administration - Expert
• Customer Service - Expert

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