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Remote Blue Cross High Dollar Insurance Follow-up Representative
Job Description Summary:
The Insurance Account Representative owns a portfolio of accounts within Excalibur’s Client Partner’s Non-Government 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.
- 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.
- High Dollar Blue Cross Resolution.
- Patient-Centric Customer Service.
- Multi-system toggling and organizational efficiency.
- Documentation, written and verbal communication.
Additional Requirements or Preferred Experience Include:
- Proficiency in Microsoft Office Products including Word, PowerPoint and Excel.
- Understanding of 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 and Follow Up.
Education:
- High School Diploma or equivalent is required for this position.
Job Type: Full-time
Pay: $18.00 - $25.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: Remote
