INSURANCE ACCOUNT REPS BOSS - Call Center - (Work Remote within 25 miles from Rawlins)
Posted on: May 15, 2022
Job Category: Collections & Operations
Requisition Number: INSUR001655
Rawlins, WY 82301, USA Job Details Description ESSENTIAL FUNCTIONS
FOR INSURANCE FOLLOW-UP:
- Communicate with insurance companies regarding the status of a
- Prepare and submit appeals on insurance denials.
- Review self-pay balances that have insurance denials needing
write-off. Adjustment requests are typically sent back to the
client & FAC will monitor until the adjustment has been
- Complete insurance payment/adjustment audits on accounts.
- Take insurance information that is provided by either the
consumer or insurance company and supply that information to the
client or load the insurance into the client system and submit
- Review all insurance faxes that are received and update the
accounts appropriately. Faxes typically request medical records,
insurance registration updates, coding review requests, etc. Many
insurance faxes are received not only on self-pay balances but
balances that are still pending with insurance.
- Utilize available client systems to ensure we are not providing
the client with insurance information that has already been
- Utilize available client systems to monitor the status of
accounts after the claim has been filed to insurance.
- Utilize available client systems to check for insurance
payments and adjustments.
- Serve as the first line of review for all self-pay and/or
insurance balances that need an additional review on the insurance
- Perform other duties as assigned. ESSENTIAL FUNCTIONS FOR
- Ensure that referrals are addressed in a timely manner.
- Navigate, document, & use various client systems, payer
websites, and other online resources.
- Follow approved guidelines, work in assigned work queues, and
prioritize accounts as instructed/advised by the manager and/or
- Initiate authorization requests via the web, fax, or phone
calls to insurance companies.
- Answer clinical questions about the patient's condition to
obtain the authorization prior to the date of service.
- Communicate with the doctor in a professional manner in cases
where the company needs additional information about the patient;
i.e., a case has been denied and the company needs the provider to
call the insurance to speak with the nurse and advise of
authorization when necessary.
- Establish and maintains relationships with identified service
- Be the system navigator and point of contact for patients and
families having direct access to asking questions and raising
- Assemble information concerning the patient's clinical
background and referral needs.
- Perform other duties as assigned. ESSENTIAL FUNCTIONS FOR
- Politely and promptly answers telephone calls.
- Correctly identify and collect patient demographic information
in accordance with company and/or hospital standards.
- Schedule appointments in the centralized scheduling system, in
accordance with service standards using scripted language for
greeting the caller, reviewing the scheduling activity, and
summarizing the transaction at the end of the call.
- Consistently adhere to high standards of customer service.
- Is proactive in preventing issues with a patient visit by
double-checking type of test, preps required, assuring no conflict
with other tests, verifying time and location, communicating and
documenting order retrieval in notes for check-in person.
- Communicate information to the patient regarding questions
about physician referrals, insurance referrals, and
- Document (when necessary) account notes in scheduling and
- Identify and work to minimize the potential financial risk of
patient accounts through financial reports, systems information, or
- Assess and communicate coverage limitations and payment
expectations with patients.
- Facilitate the pre-authorization of diagnostic exams, between
referring physicians and insurance carriers, using online tools,
worklists, and direct phone calls as necessary.
- Respond to questions and concerns.
- Perform other duties as assigned.
Work Hours: Monday - Friday 8 am to 5 pm QUALIFICATIONS To perform
this job successfully, an individual must be able to perform each
essential function satisfactorily, with or without reasonable
accommodation. The requirements listed below are representative of
the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities
to perform the essential functions. EDUCATION and/or EXPERIENCE
- GED, High School diploma, or equivalent required.
- 1-2 years of experience in the Insurance Industry, is
- Previous experience in customer service, collections, or a
related role is preferred.
- Ability to work in a fast-paced environment
- Ability to communicate clearly and briefly, utilizing proper
grammar and telephone etiquette.
- Prior PC and keyboard knowledge is a mandatory
- Ability to compute basic math calculations using addition,
subtraction, multiplication, division, and percentages. KNOWLEDGE
- Knowledge of federal, state, and local laws, regulations, and
rules concerning the insurance industry.
- Must possess interpersonal skills to handle sensitive and
- Position continually requires demonstrated self-confidence,
skill, and diplomacy.
- Proven ability to organize and motivate.
- Communicate clearly, concisely, and effectively both verbally
and written, bilingual in Spanish a plus
- Must have a working knowledge of a Windows-based system;
experience in word processing, email, and Excel is a plus
- Some analytical ability is required to gather information from
consumers, find solutions and prioritize work.
- Work requires continual attention to detail in data entry of
information related to consumer interactions.
- Knowledge of healthcare and/or insurance practices preferred.
SKILLS & ABILITIES
- Strong listening skills - Ability to listen and understand
- Exceptional customer service skills consisting of verbal and
- Ability to converse and respond to common inquiries from
consumers and members of the general public.
- Ability to write business-related documents such as letters,
emails, and other business correspondence as needed.
- Analytical and problem-solving skills.
- Strong individual work ethic possessing the ability to work
within a team highly driven, self-starter with the ability to work
independently as well as contribute to a team environment.
- Ability to define problems, collect data, establish facts, and
draw valid conclusions. PHYSICAL DEMANDS The physical demands
described here are representative of those that must be met by an
employee to successfully perform the essential functions of this
job. Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functions. While
performing the duties of this job, the employee is regularly
required to sit, talk and hear. The employee frequently is required
to use their hands to dial a telephone, utilize a computer keyboard
and mouse, and operate office equipment. The employee is
occasionally required to stand, walk, and reach with hands and
arms, as well as lift up to 20 pounds. WORK ENVIRONMENT The
employee works in a temperature-controlled office environment. The
employee sits at a desk during regularly scheduled work hours,
answers and makes telephone calls using a telephone, types on a
computer keyboard, and reads and comprehends information from a
computer system and written resources. Frost-Arnett Company extends
equal employment opportunities to qualified applicants and
employees on an equal basis regardless of an individual's age,
race, color, sex, religion, national origin, disability, veteran
status, sexual orientation, or any other reason prohibited by law.
Qualifications Education High School or better. Experience 0-1
years: How many years' do you have in insurance follow-up?
Keywords: Frost-Arnett, Wyoming , INSURANCE ACCOUNT REPS BOSS - Call Center - (Work Remote within 25 miles from Rawlins), Other , Wyoming, Michigan
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