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State of New Mexico

Office Support Clerk-Finance (DOH/NMBHI #12673)

Entry-Level JobVerifiedNo experience needed

Career Insights for Claims Representative

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Based on New Mexico 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.

$49,084 / year median in New Mexico

+2% projected growth

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Job Description

Posting Details This posting will be used for ongoing recruitment and may close at any time. Applicant lists may be screened more than once. Why does the job exist? The NMBHI Reimbursement Department plays a primary role in offering great customer service to our facility, vendors, patients, clients, and residents. The purpose of this position is to be responsible for the timely follow-up of all outstanding insurance claims, with payers to include but are not limited to Medicare, Medicaid, and commercial health insurance carriers. How does it get done? Incumbent will have a working knowledge of Windows, MS office, Outlook and Internet Explorer; will have experience in how to work in collaborative interaction with insurance representatives, other staff members and management, for accurate processing of all follow-up on claim status, non-paid accounts, denied and rejected claims; experience obtaining status of outstanding claims listed in the follow-up work AR reports and attempt to resolve. Forward issues which cannot be corrected to next level in the correct format with problems noted; experience adjusting Patient/Client/Resident accounts as appropriate in alignment with established procedures' experience answering all patient or insurance telephone inquiries pertaining to assigned accounts; experience ensuring client confidentiality in accordance of HIPPA policy; be required to attend all mandatory annual staff development trainings required by NMBHI and DOH. be required to file documents either numerically or alphabetically. Perform other miscellaneous duties as designated by management. Who are the customers? Vendors/Patients/Clients/Residents/NMBHI Staff Ideal Candidate Vendors/Patients/Clients/Residents/NMBHI Staff Minimum Qualification No prior experience or training required. Employment Requirements Must possess and maintain a valid NM Drivers License. Working Conditions Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT) and extensive personal computer and phone usage. Some sitting, standing, bending, and reaching may be required. Direct client interaction and some travel may be required. Supplemental Information Do you know what Total Compensation is? Click here
Agency Contact Information:
Grace Armijo (505)454-2225
Email Agency Contact Information:
Kaylene Maldonado (505)454--2371 Email For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement. Bargaining Unit Position This position is covered by a collective bargaining agreement and all terms/conditions of that agreement apply and must be adhered to.