Insurance Representative
Good Samaritan Society, Lansing, MI, United States
Job Details
Facility: Remote MI (Central Time)
Location: Remote, MI
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $16.00 - $25.50
Job Summary The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement. Must understand and be able to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Proactively identifies and performs account follow‑up on outstanding insurance balances and takes necessary action for account resolution in accordance with established federal and state regulations. Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials. Uses advanced knowledge and understanding to process payer rejections. Conducts trend analyses, appeals and resolves low payment or underpaid accounts. Provides input for payer‑specific meetings. Handles difficult account situations and resolves issues delaying or preventing payments from payers. Performs miscellaneous job‑related duties as requested.
Responsibilities
Consistently demonstrate accuracy in correcting (identified through pre‑edits) and submitting claims to payers.
Ensure accounts are billed in a timely manner.
Report to a manager any accounts that cannot be finished in a timely manner.
When claims are disputed, consistently utilize the correct resources to ensure the completion of the claim.
Accurately and completely follow the claim through the entire billing process.
Ensure all claims consistently meet compliance regulations.
Demonstrate accountability by consistently using appropriate resources and channels to problem‑solve issues.
Input data accurately into the computer system.
Answer the telephone courteously.
Maintain and update computer skills as needed for work assignments.
Utilize software applications for maximum efficiency.
Ensure verbal communication is courteous, complete, and professional whether using phone or personal contact.
Ensure written communication is accurate, complete and professional in presentation whether word processing or using email.
Identify and promptly resolve billing complaints.
Direct issues to supervisor when unable to resolve.
Document all contacts regarding patient accounts in the computer system.
Depending on location, may verify demographics, identify appropriate third‑party insurance/payers, set up insurance, initiate patient financial assistance.
Contact the insured or financially responsible party to obtain missing information.
Verify, create or update patient accounts for billing, prepare insurance claims forms or related documents, and verify completeness and accuracy.
Qualifications
High school diploma or equivalent preferred; post‑secondary or trade courses in accounting, business, and communications would be helpful for this position.
Six months' related work experience required.
Computer skills essential.
When applicable and if desired, leadership may require related experience to the Associate Insurance Representative at Sanford Health for internal applicants.
Benefits Sanford offers an attractive benefits package for qualifying full‑time and part‑time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home‑work balance. For more information about Total Rewards, visit sanfordcareers.com/benefits.
Employment Eligibility Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org.
Sanford has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre‑employment background screening as a condition of employment.
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Facility: Remote MI (Central Time)
Location: Remote, MI
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $16.00 - $25.50
Job Summary The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement. Must understand and be able to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Proactively identifies and performs account follow‑up on outstanding insurance balances and takes necessary action for account resolution in accordance with established federal and state regulations. Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials. Uses advanced knowledge and understanding to process payer rejections. Conducts trend analyses, appeals and resolves low payment or underpaid accounts. Provides input for payer‑specific meetings. Handles difficult account situations and resolves issues delaying or preventing payments from payers. Performs miscellaneous job‑related duties as requested.
Responsibilities
Consistently demonstrate accuracy in correcting (identified through pre‑edits) and submitting claims to payers.
Ensure accounts are billed in a timely manner.
Report to a manager any accounts that cannot be finished in a timely manner.
When claims are disputed, consistently utilize the correct resources to ensure the completion of the claim.
Accurately and completely follow the claim through the entire billing process.
Ensure all claims consistently meet compliance regulations.
Demonstrate accountability by consistently using appropriate resources and channels to problem‑solve issues.
Input data accurately into the computer system.
Answer the telephone courteously.
Maintain and update computer skills as needed for work assignments.
Utilize software applications for maximum efficiency.
Ensure verbal communication is courteous, complete, and professional whether using phone or personal contact.
Ensure written communication is accurate, complete and professional in presentation whether word processing or using email.
Identify and promptly resolve billing complaints.
Direct issues to supervisor when unable to resolve.
Document all contacts regarding patient accounts in the computer system.
Depending on location, may verify demographics, identify appropriate third‑party insurance/payers, set up insurance, initiate patient financial assistance.
Contact the insured or financially responsible party to obtain missing information.
Verify, create or update patient accounts for billing, prepare insurance claims forms or related documents, and verify completeness and accuracy.
Qualifications
High school diploma or equivalent preferred; post‑secondary or trade courses in accounting, business, and communications would be helpful for this position.
Six months' related work experience required.
Computer skills essential.
When applicable and if desired, leadership may require related experience to the Associate Insurance Representative at Sanford Health for internal applicants.
Benefits Sanford offers an attractive benefits package for qualifying full‑time and part‑time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home‑work balance. For more information about Total Rewards, visit sanfordcareers.com/benefits.
Employment Eligibility Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org.
Sanford has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre‑employment background screening as a condition of employment.
#J-18808-Ljbffr