Patient Accounts Claims Submission Representative

Responsibilities include, but are not limited to, the following:

• Preparing claims for electronic claims submission through a clearinghouse or direct submission to the insurance payer;
• Preparing paper claims for submissions via mail; attaching medical records when necessary for claim processing;
• Retrieving correspondence received from the clearinghouse or insurance company via mail and resolving all rejected claims for resubmission;
• Updating the billing system with necessary corrections for claims submission;
• Troubleshooting claims submissions;
• Maintaining a daily log of all uploaded, sent, and rejected claims;
• Establishing and maintaining a professional relationship with the clearinghouse and all insurance Electronic Data Interchange (EDI) department personnel and co-workers;
• Working with the Insurance Specialists to ensure proper filing of claims;
• Operating, using, and maintaining office equipment as trained.

Minimum education and professional requirements include, but are not limited to, the following:

• High school graduate or equivalent;
• Employee must be 18 years or older;
• Typing experience required;
• Knowledge of general insurance policies;
• Excellent written and verbal communication skills;
• Ability to prioritize, organize, and multitask in a timely manner;
• Proficiency in Microsoft Office (e.g., Excel, Word, and Outlook);
• Ability to use phone system;
• Ability to sit for long periods of time (up to eight hours at one time);
• At least three years of experience working in the health care field in a medical billing department preferred;
• Electronic claims submission experience;
• Certified Professional Coder (CPC) or Certified Professional Coder Apprentice (CPC-A) experience.