Remote Blue Cross High Dollar Insurance Follow-up Representative

Remote Full-time
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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