Medical Insurance follow-up, claims research .
Client Insurance Representative opportunity • Now hiring!!
Are you good with people? Have experience researching medical claims?
Do you want to join a growing organization that needs good people?
Parallon is a growing organization supporting one of the largest healthcare systems in the country offering Career advancement, learning opportunities and great employee benefits!
Position Summary: Process medical insurance accounts to address claim issues and to affect payment and/or bringing them to resolution. Research claim status with carriers via various portals to reach resolution and payment of claims.
Essential Job Functions :
1.Status account and document all work performed in the company and client computer systems.
2.Assess accounts to determine the next appropriate course of action in line with company policies and procedures.
3.Place outbound calls to insurance companies, guarantors, patients, doctors' offices and/or facilities and handle incoming calls as necessary utilizing proper customer service protocol.
4.Process related correspondence from insurance companies and perform pertinent follow-up.
5.Reconcile balances and payments between insurance companies and clients computer systems.
6.Escalate issues to Team Lead or Manager as necessary.
7.Other duties as assigned by management
8.Duties may vary by location
Experience on resume with the following systems helpful, but not required:
GE practice management systems IDX, NextGen, Centricity, TES/ETM webflow experience; E-Clinical; Next Gen PM system; and Medical Manager, Epic, Touch Works, Signature, EPIC, Tiger and Emdeon
Experience with anesthesiology helpful, but not required.
•Knowledge: Medical and insurance terminology (such as procedure codes, diagnoses, and patient liability), and full understanding of hospital/physician billing. Ability to read and understand EOB statements. Understanding of co-pay, co-insurance, primary and secondary payer in regards to medical insurance coverage, paper and electronic claims processing.
•Education: High school diploma or equivalent
•Experience: Minimum 1-2 years experience in Medical Billing/Follow-up for a facility, medical clinic, or doctor's office and experience with Microsoft Office suite and standard office equipment (copier, fax machine) a must.
•Skills/Aptitudes: Demonstrated communication and problem solving skills and the ability to act/decide accordingly. Ability to collect, create and research complex or diverse information. Exceptional customer service and the ability to plan organize and exercise sound judgment.
A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom