Insurance Clerk I

JOB SUMMARY:

The Billing Department is seeking an Insurance Clerk I. Professional candidate is responsible for accounts receivable functions for insurance plans and third party payors, under the guidance of regulatory and contractual requirements.

PRIMARY FUNCTIONS:

 Prepare and file insurance claims in accordance with insurance carrier’s regulatory and contractual requirements.

 Review, correct and reconcile rejections from clearing house or CIMOR system.   

Review, reconcile and post remittance advices (RA) or explanations of benefits (EOB) as received for assigned insurance carriers.

Process, correct or adjust denied claims and overpayments for assigned insurance carriers.   Work with other departments in obtaining insurance information as needed to file or correct claims for assigned insurance carriers.

Review and process open items reports for insurance carriers assigned.

Verify insurance eligibility for scheduled appointments.

Process collection of deductibles and co-insurance for insurance carriers assigned.

Work with other departments in obtaining insurance information as needed to file or correct claims for assigned insurance carriers and patient accounts.

Other related duties as assigned by Billing Manager.

QUALIFICIATIONS:

  1.  Two (2) year’s experience in claim processing and verifying insurance eligibility preferred.

  2.  High school graduate or G.E.D.

  3.  Must have experience working with Microsoft office products and Web based insurance programs.

  4.  Attention to detail and accuracy a must.