Insurance Representative

General Summary: A nonexempt position responsible for the proper and timely processing of claims and payments to providers.

Essential Job Responsibilities:

• Weekly review of claim edits reports and corrects the claim information such as (CPTs, valid ICD-10's, referring doctor name/UPIN #, modifiers, etc.).
• Work and corrects claim rejections from Navicure, correcting necessary data.
• Daily follow-up of aged and denied charges.
• Keep A/R Supervisor informed on all Payer problems.
• Contacting insurance carriers via phone or website.
• Handle patient and provider calls in reference to claims or statements.
• Answer and forward incoming calls in a timely manner.
• Identifies and resolves patient billing complaints.
• Performs various collection actions including contacting patients by phone, correcting, and resubmitting claims to third party payers.
• Identify and correct posting errors and overpayments.
• Review and correct COB errors.
• Other duties and projects as assigned.
• Occasional overtime may be required.