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Insurance Representative Full-time

at Excalibur DDPM New York in New York (Published at 09-08-2022)

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.
  • Team Player.
  • Passion for Healthcare.

Education:

  • High School Diploma or equivalent is required for this position.

Job Types: Full-time, Part-time

Pay: From $16.00 per hour

Benefits:

  • Health insurance
  • Paid time off

Schedule:

  • Monday to Friday

Supplemental Pay:

  • Bonus pay

Application Question(s):

  • Are you familiar with EOB's?

Experience:

  • Healthcare Insurance Follow Up: 1 year (Required)
  • Healthcare Admin: 1 year (Required)

Work Location: Remote



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