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MS
Medix Staffing Solutions
Insurance Advisor
Career Insights for Claims Representative
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Based on Delaware data
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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.
$53,895 / year median in Delaware
+2% projected growth
Job Description
You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is seeking an experienced Insurance Advisor to manage accounts, resolve claims efficiently, and handle various collection actions. The primary goal is to ensure prompt payment and resolution of unpaid claims. Key Responsibilities Perform various collection actions, including contacting patients and insurance by phone or website. Professionally communicate and resolve claims with insurance carrier representatives and build relationships that assist in processing claims efficiently. Understand and resolve rejections, denials, insufficient payments, and unpaid claims. Correct, resubmit, and appeal claims to third-party payers. Accurately enter and/or update patient demographics, insurance information, and other pertinent account information. Monitor, analyze, and communicate accounts receivable challenges and opportunities to management. Report payor issues and trends, including the number of accounts and dollars associated with the issue. Handle daily correspondence and accomplish projects as a team member or individual as assigned. Comply with established policies, procedures, objectives, HIPAA, and safety standards. Qualifications Familiarity with ICD 10 and CPT Codes. 3 years of denials experience. Knowledge of commercial and government insurance. EPIC experience is preferred. Experience 3 years of denials experience in insurance advisory or related field.