Insurance Clerk

3 weeks ago


Green Bay, United States Prevea Health Full time

Insurance Clerk

Come work where we specialize in you
We have nearly 2,000 reasons for you to consider a career with Prevea Health-they're our employees. We're an organization that values kindness, responsibility, inclusivity, wellness and inspiration. At Prevea, we provide continuous education, training and support so every member of the team contributes to our success. Together we are the best place to get care and the best place to give care.

Job Summary
Providing exceptional care for our patients as well as recognizing the value of your co-workers is the expectation of all members of the Prevea Health organization. All members are expected to focus on the patient's needs; relate to all in a friendly, accepting manner, communicate in a positive and professional way to patients and co workers; use time effectively and efficiently; demonstrate an overall high level of performance. The Insurance Clerk will work to resolve commercial insurance denials, monitor aged receivables for commercial insurance, and follow-up with insurance carriers.

What you will do
  • Respond and investigate denials by insurance carrier. Draft appeal letters, as necessary.
  • Follow-up on improperly paid claims.
  • Monitor aged receivables for commercial insurance bill types and follow-up with insurance carriers.
  • Work problem accounts and resolve them in satisfactory manner.
  • Answer patient account questions by phone in a professional, tactful and friendly manner, communicates on a need to know basis.
  • Attends required meetings and participates in committees as requested.

Education Qualifications
  • High School Diploma and/or GED Required
Experience Qualifications
  • 1-3 years Minimum 2-3 years experience in an insurance or health care setting. Required
  • Previous experience in customer service.
    Required
  • Experience with computers and Windows based applications. Required
Skills and Abilities
  • Strong knowledge of commercial insurance billing policy and procedures.
  • Ability to work independently and as a team, while performing responsibilities efficiently and accurately.
  • Strong investigative skills.
  • Computer experience and 10 key proficiency.
  • Excellent organizational skills.
  • Excellent communication skills with internal and external customers.
  • Knowledge of CPT/ICD-9 codes and usual and customary charges.
  • Word processing and computer experience with Excel, Word and Windows based applications.
  • Ability to process and hand confidential information with discretion.
Physical Demands
  • Sit - Constantly
  • Stand - Occasionally
  • Walk - Occasionally
  • Drive - Rarely
  • Bend (Neck) - Frequently
  • Gross Manipulation (Hands/Arms) - Frequently
  • Squat - Occasionally
  • Twist/Turn (Neck) - Frequently
  • Twist/Turn(Waist) - Occasionally
  • Lift/Carry 0-10 lbs. - Frequently
  • Lift/Carry 11-25 lbs. - Occasionally
  • Lift/Carry 26-35 lbs. - Occasionally
  • Lift/Carry 36-50 lbs. - Rarely
  • Push/Pull 11-25 lbs. - Rarely
  • Push/Pull 26-35 lbs. - Rarely
  • Reach (Above shoulder level) - Rarely
  • Reach (Below shoulder level) - Constantly
  • Simple Grasping (Hands/Arms) - Constantly
  • Fine Manipulation (Hands/Arms) - Constantly
  • Gross Manipulation (Hands/Arms) - Frequently

Working Conditions
  • Noise - Occasionally

Hearing Requirements
  • Hears Whispers < 3 feet - Constantly
  • Hears Whispers 3-8 feet - Constantly

Vision Requirements
  • Color Discrimination - Constantly
  • Near Vision (Correctable to Jaeger 2 or 20/30 binocular) - Constantly
  • Distance Vision (Correctable to Snellen chart 20/30 binocular) - Constantly

Prevea is an Equal Employment Opportunity/Affirmative Action employer. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire. Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
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