Associate Insurance Representative

Sanford Health the largest rural health system in the United States is dedicated to transforming the health care experience and providing access to world-class health care in Americas heartland.

Work Shift:

8 Hours - Day Shifts (United States of America)

Scheduled Weekly Hours:

40

Compensation:

Salary Range: $15.00 - $23.00

Union Position:

No

Department Details

Summary

The Associate Insurance Representative processes and monitors unpaid third party insurance Medicare Medicaid or government-assisted program accounts for proper reimbursement; primarily but not limited to prebilled accounts.

Job Description

Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Processes daily workflow changes that depending on department may include eligibility verification verification of information payment postings initiating refunds processing month end resolving and troubleshooting incidents reporting initial billings and re-billings of claims scanning and indexing of documents and be the point of contact to provide assistance as needed. Responsible for assuring accounts are set up correctly with the information available is completed timely and work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials that are technical in nature (i.e.: records required denials). Performs miscellaneous job related duties as requested.

Qualifications

High school diploma or equivalent preferred.

Previous billing experience preferred.

Sanford is an EEO/AA Employer M/F/Disability/Vet.

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