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CULLMAN REGIONAL

INSURANCE SPECIALIST (13852)

Career Insights for Claims Representative

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What they do

A Claims Representative accepts and reviews applications for insurance and provides information to insurance agents. Assists insurance customers, answers questions and processes requests to change or cancel policies. May assist with insurance claims that are disputed, review claims and policy coverage and help to negotiate agreements between customers and an insurance company.

$53,596 / year median in Alabama

+3% projected growth

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Job Description

INSURANCE SPECIALIST
(13852) Cullman Regional Medical Center - Cullman, AL 35056 Apply Overview Position Type Full Time Job Shift Any Category Health Care Apply Description Job Summary Identifies status on unpaid 3rd party claims in a timely manner. Uses most effective tools to obtain status so that effectiveness and productivity are maximized. Communicates payment expectations and removes payers stall tactics in a firm but professional manner. Reports problem accounts and/or consistent slow payers to management and provides examples. Involves the patient and/or insured to obtain information needed by payers to process the claim. Conducts three-way calls between patients and payers to address obstacles in getting claims processed. Obtains, or assists in obtaining, any additional documentation needed by a payer to process a claim. Works with their billing partner to identify trends in billing errors, so the edits can be developed to increase clean claim rate. Accurately and thoroughly documents all pertinent events regarding the account. Demonstrates and encourages team behavior and exceptional patient/guest experiences. Upholds and promotes patient safety and quality. Qualifications Education High school diploma required or equivalent. Experience 3 years of hospital business office or physician office preferred. Additional Skills/Abilities Must be proficient in Microsoft Office Suite of products. Knowledge of ICD, CPT, revenue codes and modifiers is required. Familiarity with payer website and portals is preferred. Share job details to