Job Description Summary:
The Insurance Account Representative owns a portfolio of accounts within Excalibur’s Client Partner’s Government, Non-Government, TPL or Worker’s Compensation Accounts Receivable.
This position is responsible for the rapid, compliant and patient-centric resolution of balances and the maximization of Excalibur’s Client Partner’s financial performance.
Key Tasks and Deliverables:
The Insurance Account Representative performs the following key tasks and is responsible for the following key deliverables:
- Whether via website, portal or phone call, performs follow up with an aim towards the collection and resolution of assigned insurance balances.
- Leverages understanding of managed care contracts, Payer behaviors and clean claim statutes to influence the intent of the Payer and overcome objections or delays to payment.
- Understands expected reimbursement on assigned Payer (s); identifies and attempts to resolve and prevent payment discrepancies.
- Submits/Re-submits UB-04, 1500 and/or other applicable Claim forms; accurately populating each field locator and attaching all associated documentation (to include Itemized Statements, Medical Records etc) where the Billing/Re-Billing function is assigned to Excalibur.
- Works with Payers and Patients to resolve coverage, coordination of benefits and authorization issues that may impact resolution of a claim.
- Manages printing and mailing Claims.
- Consistently documents all Payer and Patient encounters in Hospital’s source system and/or Excalibur’s workflow solution.
Skill Sets and Experience:
The Insurance Account Representative must be able to demonstrate an ongoing command of the following:
- Components of the UB-04 and CMS 1500 forms.
- Thorough content knowledge of all Client Policy Statements, Procedures, Process Maps and other documentation.
- Patient-Centric Customer Service.
- Multi-system toggling and organizational efficiency.
- Documentation, written and verbal communication.
Other Requirements:
Additional Requirements or Preferred Experience Include:
- Proficiency in Microsoft Office Products including Word, PowerPoint and Excel.
- Understanding of Gov't and Non Gov't Payers.
- HIPAA and related Privacy and Security Acts and Regulations.
- Excellent Communication Skills and an ability to connect with leaders and staff.
Education:
- High School Diploma or equivalent is required for this position.
Job Type: Full-time
Pay: $17.00 - $19.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
Work setting:
Application Question(s):
- Are you familiar with EOB's?
- What EMR systems are you familiar with?
- Please describe payers that you are familiar working with
Experience:
- Healthcare Insurance Follow Up: 2 years (Required)
Language:
- any other languages, if so, explain (Preferred)
Work Location: Remote