Insurance Representative I

Job Description

Job Description

Insurance Representative

FLSA: Non-Exempt

About us

Physicians East, P.A.is a team of skilled healthcare professionals united to meet the challenge of delivering quality, cost-efficient, comprehensive healthcare to the people of Eastern North Carolina.

About the role

We are looking for an employee who poses the qualities to review claim edits for submission to insurance carries. Review and work A/R reports which includes review of outstanding pending claims (primary, secondary, and tertiary) credit accounts and patient billing. Contact insurance companies to verify and resolve any claim issues which includes review of denials. Identify and monitor denial trends and report findings to insurance supervisor. Maintain working knowledge of all insurance carries guidelines. Communicate effectively with insurance carriers, insurance and billing staff and management.

Supervision Received: Reports to Insurance and Billing Supervisor.

Supervision Exercised: None.

Typical Physical Demands: Requires prolonged standing or sitting while working in an office environment. Requires some bending or stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and other office equipment.

Typical Working Conditions:

Normal office environment.

Responsibilities

• Review of claim edits for submission to Insurance carrier

• Review of A/R reports which includes outstanding pending claim, insurance/patient credits and patient billing

• Contact insurance companies to verify and resolve claim issues and denials

• Verification of insurance eligibility and benefits

• Utilization of insurance web-based resources

• Thorough examination of patient accounts to ensure account accuracy

• Identify and monitor denial trends and report findings to management

• Maintain working knowledge of all insurance carriers’ guidelines

• Review and complete tasks assigned from Practice Management System

• Communicate effectively with insurance carriers, billing staff and management

Location & commitments

Full-time role based at our Greenville Arlington Blvd. location, Monday-Friday, 8a.m. – 5 p.m.

Overtime may be required to ensure patients are taken care, tasks are completed, and calls are returned in a timely manner.

Weekend work is rare but can occasionally be necessary.

Candidate requirements

Minimum of 1-3 years’ experience in insurance and billing setting and or appropriate college education required. Knowledge of Nextgen would be helpful but not required. Working knowledge of PC and Window bases products. Accuracy in key punch operations including adding machine. Must have a strong sense of team commitment, which includes meeting deadlines, punctuality, and excellent follow through and feedback. Must display a high level of integrity and initiative.

Affirmative Action/EEO statement

Physicians East, P.A.is an equal opportunity employer and will not discriminate against any applicant or employee on the basis of age, race, color, ethnicity, religion, creed, sex (including gender, pregnancy, sexual orientation, and gender identity, which includes status as a transgender individual), national origin or ancestry, citizenship, past, current, or prospective service in the uniformed services, genetic information (including family medical history), physical or mental disability, or other legally protected status. Reasonable accommodation will be made for persons with disabilities during the application process and/or at the time of employment. Requests for accommodation should be made to the Human Resources Department as early as possible in the application/employment process. Contact HR Office at 252-413-6368 or email [email protected]

Disclaimer

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Signatures

This job description has been approved by:

Manager_____________________________________ Date ____________

HR__________________________________________ Date _________________

Employee signature below indicates the employee's understanding of the requirements, essential functions, and duties of the position.

Employee______________________________________ Date__________________