Description
Insurance Services Rep I
Overview:
Productivity - Maintains daily work assigned to assure low A/R days. -
Maintains or exceeds productivity standards on a daily, weekly, monthly basis- Maintains a current status of work queue and follows up in a timely manner. - Completes assignments in the prescribed time periods and with efficiency and attention to detail.Quality.
Maintains acceptable quality standards per department requirements. -
Effective and efficient troubleshooting of underpaid and denied claims- Communicates effectively with co-workers/third party payers to successfully resolve outstanding insurance receivables. -
Accurately and efficiently processes the account including transaction recording, claim corrections and other functions.
Communication- Works effectively with other staff members to accomplish work and departmental projects.- Interacts by telephone with other departments, physician offices and third party payers.-
Demonstrates positive and professional communications skills.System Proficiency -
Uses and demonstrates a understanding of the patient accounting computer system.-
Maintains technical knowledge and skills of all computer applications, including but not limited to EPIC, SSI, Microsoft Office, and third party insurance applications.- Maintains current EPIC/Systoc proficiency level for applicable role (EUPA = End User Proficiency Assessment).Knowledge - Stays abreast of contract, regulatory, procedural and other changes affecting the department.- Demonstrates an understanding of UB04/CMS1505 claim forms and corresponding date elements.- Demonstrates an understanding of third party requirements/regulations which allows effective job performance.- Demonstrates an understanding of hospital and physician reimbursement methodologies- Strong understanding of HIPPA laws.Mission Performs duties consistent with the mission, values and Mercy Service Standards.MiscellaneousPerforms other duties as assigned.
Qualifications:
- HS Degree
- Other Skills :Basic Microsoft Excel and Word knowledge. Communication and customer service skills
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