Insurance Representative

THE PORTLAND CLINIC

JOB DESCRIPTION


JOB TITLE: Insurance Representative

SUPERVISOR: Business Services Manager

Hours Per Week: 40/non-exempt

DEPARTMENT: Business Services


The following information is designed to outline the essential functions and position requirements of this job. It does not identify all tasks that may be expected, nor address the performance standards that must be maintained.


PRIMARY FUNCTION: Position is responsible for facilitating efficient management of business services insurance processes.


DUTIES & RESPONSIBILITIES: ( ESSENTIAL FUNCTIONS)
1. Open, sort, distribute and/or process insurance correspondence.
2. Answer telephone and respond to patient, staff and insurance company inquiries.
3. Obtain necessary billing information from patients; maintain computer insurance screen to aid in billing process, and bill insurance directly if applicable.
4. Assist patients and staff with insurance related inquiries regarding eligibility, benefits, and account maintenance.
5. Process and manage delegated Insurance Company accounts, claims, vouchers, adjustments, appeals and refunds.
6. Review and work all assigned work queues including but not limited to: claim edits, insurances, accounts, credits to resolve outstanding claims and account concerns.
7. Provide orientation, handouts, and continued education for all Clinic staff on insurance changes and information.
8. Maintain Policy and Procedure for each assigned responsibility.
9. Attend internal and external meetings as requested by Supervisor.
10. Attend work as regularly scheduled.


EDUCATION/LICENSES REQUIRED:
High School Diploma or equivalent


EXPERIENCE/QUALIFICATIONS/SKILLS PREFERRED:
Values team success
Compassionate, patient, tactful, diplomatic, sociable, well organized, thorough, and independent
Shows an interest in taking action to increase his/her knowledge and development as an employee
Contributes to an environment where people feel valued
Strong keyboarding skills (50wpm)
Current diagnosis and procedural coding
Electronic Health Record competency
Proficiency in medical software and Microsoft Windows
Organizational skills and ability to prioritize work flow
Oral communication skills and excellent phone etiquette with an ability to convey and receive information via the telephone
Competency in language, grammar, and spelling
Ability to interact and establish a good rapport with people over the telephone and in person, often in stressful situations
Capability of effectively working on more than one task without a reduction in the quality of work and service performed
Ability to react calmly and effectively in emergency situations and to work under pressure
Ability to accept responsibility and use initiative to proceed with necessary tasks without direct supervision
Skill in establishing and maintaining effective working relationships with patients and staff




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