Insurance Processing Job Description
Under the direction of assigned management, prepares and submits reports, monitors and expedites payments, initiates claims research and maintains ongoing communications regarding collections and open claims. Is Insurance Processing accountable for preparation of bank deposit information and prepares and submits month-end balancing information to management. Performs other related clerical, accounting and administrative duties germane to the function as assigned.
Insurance Processing Job Essential Responsibilities/Accountabilities
- In accordance with the medical center’s Billing policy, will monitor the status of open claims taking appropriate action to expedite payments.
- Insurance Processing Works with an AR Aging report to identify past due claim information. Prepares files or paper claims for submission. Works directly with insurance carriers and provider representatives. Maintains ongoing communications regarding collection problems and open claims.
- Applies and maintains a record (billing journal) of all payments received through both an electronic (ERA) file and/or paper remittances. Accountable for preparation of bank deposit information related to assigned carriers. Will also prepare and submit month-end balancing information to management during a designated timeframe.
- Performs a variety of related duties such as developing reports to initiate the scrubbing of claims; preparing both files and paper depending on both system and carrier needs; apply payments, research and resolution of denials related to both carrier and clearing house issues.
- Insurance Processing Prepares itemized statements for medical center patients. Works closely with Business Office/Collection Department staff, conducts research to resolve coverage and insurance problems. Responds to patient billing calls and accountable for answering questions regarding both self pay and insurance related concerns.
- Insurance Processing Initiates billing and follow up for special programs such as Rabies Clinic, Flu Clinic and Referrals/Authorization requirements. Responsible for keeping management up-to-date on carrier changes and guideline requirements. Responsible to read and attend any informational session/bulletins where changes might be discussed.
- Depending on position might also be responsible to send patient statements and/or prepare paperwork when sending delinquent accounts to the designated collection agency for follow-up.
- Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values and adhering to the Corporate Code of Conduct.
- Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
- Performs other functions as assigned by management.
- Regular reliable attendance is expected and required.
- A.A.S. degree in Business Administration with concentration or emphasis in accounting and at least one year of related experience is preferred. An equivalent combination of appropriate education or training, and substantial directly related experience will be considered.
- Insurance Processing Must possess strong written and verbal communication skills.
- Capable of establishing and maintaining constructive relationships with outside professionals, patients, and all levels of staff and management. Must be diplomatic in order to deal constructively with patients regarding their account and insurance billing.
- Insurance Processing Ability to handle confidential information with the utmost discretion and confidentiality.
- Proficient in Microsoft Office and PC skills.
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