Remote Blue Cross High Dollar Insurance Follow-up Representative

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

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

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