Hospital Insurance Representative Job Description Sample
Needed Insurance Follow UP, Denial AND Billing REP FOR Hospital Claims
A dynamic Large diversified Healthcare Company located in Franklin Square, Long Island is looking for full-time INSURANCE FOLLOW UP, DENIAL AND BILLING REP FOR HOSPITAL CLAIMS: Experience with Medicaid, Medicare and Third Party billing is required.
If you are driven, pro-active and want to continue you career in insurance billing, this role could be yours.
The ideal candidate will have experience processing insurance claims and working denials for a hospital or similar origination. We are looking for motivated individuals who can work independent and as part of a team. We work with many systems, this candidate should be a quick learner and able to multi task. We are looking for thinkers who will contribute to improving our process. This position is for those who want to be an important part of the team. This is a career opportunity.
Individual must have a general knowledge of Email, MS Word and MS Excel.
Monday through Friday
Salary based on experience.
This is a career opportunity.
Training provided. This is a direct hire, we are not a recruiting agency. Please email resume
Hospital Insurance Follow-Up Manager
The Insurance Manager is primarily responsible for overseeing and ensuring effectiveness of PFS Group’s Insurance Follow- Up Department, and coordinates day-to-day operations. This position also maintains compliance of departmental policies and procedures, meeting operational and production standards, improving service levels, preparing reports, maintaining professional and technical knowledge, and accomplishing organizational goals. Reporting to the Corporate Director of Insurance and serving as a member of the organization’s Management Team, the position contributes to the development and implementation of organizational strategies, policies, and practices.
- Reasonable command of Excel, Word and Power Point for report creation and presentation
- Professional presentation, appearance, and demeanor
- Demonstrated leadership, teamwork and time management skills
- Extensive background, experience, and knowledge with Hospital Revenue Cycle
- Extensive knowledge in Commercial, State, and Government Insurance
- Ability to work well under pressure and multi-task
- Excellent communication skills, both written and verbal
- Outstanding listening, problem-solving, and researching skills
- Must be available during common hours, which can vary (may include evening and occasional weekend hours)
EDUCATION AND EXPERIENCE
- At least 3 years of successful experience in a healthcare environment managing a team of insurance follow-up FTE’s
- Demonstrated stable work history
- Understanding of CUBS computer system a plus
- Manage hospital project insurance receivables - daily
- Supervise and coach insurance department supervisor/management team on a weekly basis
- Increase management's effectiveness by recruiting, selecting, orienting, training, coaching, counseling, and disciplining department management team; communicating values, strategies, and objectives; assigning accountabilities; planning, monitoring, and appraising job results; developing incentives; developing a climate for offering information and opinions; providing educational opportunities
- Ensure employees follow the organization’s policies and procedures (personal leaves, overtime, confidentiality information)
- Develop training plans with the employees to ensure the employee skill set is at the level needed to carry out their job duties
- Provide ongoing feedback in regards to employee’s performance
- Conduct performance appraisals on a regular basis
- Assessing how the employee has performed
- Advising how the employee can improve in their job roles
All candidates will be required to undergo a pre-employment drug screen and a pre-employment national background check.
Nationwide Patient Account Management Firm.
PFS Group offers a friendly, caring work environment, competitive benefits and compensation, (dailypay option available!) medical, dental, vision, short and long-term disability, life insurance, Hospital Indemnity, Critical Illness, Accident Insurance, MDLive, a matching 401(k) with profit-sharing, etc.
About PFS Group
Based in Houston, Texas, with satellite offices in Texas, California and North Carolina, we currently work with 25+ clients who operate more than 100 hospital facilities from small, rural community medical centers to metro population center health systems. Leaders in their respective markets and nationwide, our clients rely on our services to support their accounts receivable departments.
Our commitment to the healthcare industry is also demonstrated through our sponsored and encouraged certification achievements, as well as participation in AAHAM and/or HFMA.
Teamwork, Dependability, Self-Motivation and the highest level of professional conduct are an integral part of all positions with PFS Group!
Insurance Representative/Bariatric Services/Sacred Heart Hospital Pensacola/Ft Day
Job ID: 240037
Insurance Representative/Bariatric Services/Sacred Heart Hospital Pensacola/FT Day
Additional Job Information
Sacred Heart Hospital Pensacola
Department: Bariatric Services
Additional Job Details: FT Day
Marketing Statement Thank you for your interest in Northwest Florida’s leading health care provider – Sacred Heart Health System. Northwest Florida is a growing, family-oriented community, offering a mild climate, year-round recreational opportunities and beautiful sugar-white beaches along the warm waters of the Gulf of Mexico. As part of Ascension – the largest non-profit health system in the U.S. and the world’s largest Catholic health system – Sacred Heart offers competitive salaries and a comprehensive benefits package. Our associates consistently give high ratings to their workplace engagement and leadership’s support for their well-being. Sacred Heart was founded by the Daughters of Charity in 1915. While our technology has improved dramatically and the buildings have grown and expanded, our commitment to the mission remains steadfast: to provide excellent health care to all people, with special attention to the poor and vulnerable. For our more than 100-year history, we have been blessed with talented associates who believe in our mission and are dedicated to serving our patients and families. Sacred Heart Health System includes hospital campuses in Pensacola, Miramar Beach and Port St. Joe, Florida, as well as The Studer Family Children’s Hospital at Sacred Heart – Northwest Florida’s only children’s hospital – and Sacred Heart Medical Group, the largest network of primary care and specialty physicians in Northwest Florida. In affiliation with the University of Florida, Sacred Heart offers the region’s only kidney transplant program, as well as physician residency programs to train the next generation of doctors in internal medicine, pediatrics and obstetrics/gynecology. To learn more about Sacred Heart Health System, visit www.sacred-heart.org .
The Insurance Representative determines and verifies insurance coverage and coordination of benefits from all sources.
Confirms insurance coverage. Determines necessity for pre-authorization and obtains authorization for scheduled procedures.
Enters patient insurance information into the patient record and documents insurance coverage of services to be provided.
Determines financial responsibility for services to be provided. Notifies patients and/or practitioners of any services requested and/or referred that are not authorized by insurance.
Communicates with patients and practitioners regarding financial responsibility and insurance coverage issues.
Performs other duties as assigned.
HS or Equivalent
High School or Equivalent required.
College coursework in accounting or business related subjects preferred.
- One year of experience working in a hospital, physician office or clinic setting required.
How To Apply If you are interested in joining the Sacred Heart Health System Team, please apply by completing an online application. For questions or assistance with completing the online application, please contact Ascension candidate care at 855-778-6037.
Equal Employment Opportunity Sacred Heart Health System is an equal opportunity employer. Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
Admissions Representative - Hospital Onsite
Navigant Cymetrix unites the strengths of four category-leading companies to address the complexities of today’s healthcare system. We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.
The Admissions Representative is responsible for obtaining and verifying demographic information, insurance benefits and eligibility. Assigns the correct medical record and account number; therefore, providing a database which ensures accurate billing and clinical information. This position performs any and all job related duties as assigned.
- Ensure accurate data element
- Customer service excellence
Duties to include but not limited to:
- Responsible for obtaining complete and accurate demographic and financial information from a variety of sources, including patient interviews physician offices and in-house departments.
- Obtains required signatures on legal consents and insurance forms.
- Performs required pre-certification, credit referral or deposit collection. Enters data in computer and thoroughly documents any incomplete admissions/registrations in manner prescribed. Obtains pre-certification, referral or authorization number and updates patients file.
- Notifies patients, family members, physicians and/or supervisors of insurance coverage issues, notifies patients of co-payments, deductibles or deposits needed, documenting all information in computer system.
- Reviews Physician’s orders for completion and ensures all required information is listed.
- Completes Medicare Compliance and obtains ABN if necessary.
- Knowledge of all Federal, State and Local Laws pertaining to insurance rules and regulations.
- Maintains multiple computer systems.
- Maintains positive customer service at all times, referring unresolved issues to appropriate supervisor.
- Answers telephone calls. Follows pre-established script and provide assistance to callers.
- Completes all shift duties in a timely and accurate manner.
- Complies with all safety regulations, policies and procedures as defined by Customer.
- High School Diploma or equivalent preferred.
- Basic College Courses in Healthcare Occupation preferred.
- Minimum Experience 1 year experience in a hospital setting utilizing data entry skills, insurance websites and various software applications preferred.
- Ability to type a minimum of 35 CWPM.
- Medical terminology preferred.
- Prior experience utilizing ICD-9 and CPT coding is preferred.
- Ability to greet and effectively relate to patients, physicians and staff.
- Computer skills and proficient in Microsoft Office software programs.
- Great organizational skills and the ability to set priorities and manage time effectively.
- Great interpersonal skills and the ability to communicate effectively both orally and in writing.
- Able to maintain professional demeanor in high stress environment.
- Ability to deal with pressure and complaints.
- Presents oneself in a professional manner through appearance and conduct.
- Certification/Registration Certified Healthcare Access Associates (CHAA) preferred.
- Strong conceptual, as well as quantitative and qualitative analytical skills
- Work as a member of a team as well as be a self-motivator with ability to work independently
- Constantly operates a computer and other office equipment to coordinate work
- Frequently travels by airplane, train or car as necessary to perform work at another location
- Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data
- Generally works in an office environment
NavigantCymetrix is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information or any other basis protected by law, ordinance, or regulation.
Navigant will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
Patient Access Insurance Specialist - Crittenton Hospital
Patient Access Insurance Specialist
Crittenton Hospital Rochester, MI USA Shift Days: Mon/Tues/Wed/Thurs/Fri : Shift Hours: 9:30 am
6 pm The Patient Access Insurance Specialist (PAIS) position is a part of the Financial Clearance Center (FCC), the starting gate for the patient hospital experience. PAISs are members of a strong team in a dynamic, client focused, fast paced department. The primary focus for this role is to mitigate the financial risks to our hospital clients. To do this this position is responsible for contacting patients directly and/or using alternative means to secure patient’s information such as demographics, insurance/coverage and clinical information needed to determine patient’s eligibility, coverage, and insurance limitations. Patient Access Insurance Specialist will use analytical skills to make decisions and explain coverage details so that patients completely understand what their financial responsibility will be. Associates in this role are empowered to identify additional resources and refer patients who might have difficulty meeting their financial responsibilities. Success in this role is measured with the use of weekly productivity scorecards. Hard work, exemplary performance and continuously expanding knowledge base can lead to opportunities to move up and become a great people leader at R1. Reports directly to a department Operations Supervisor and receives daily ongoing support from the PAIS Team Lead. Your day to day role will include:
Initiates contact with client hospital patients via telephone using appropriate scripting to ensure the required level of benefit and pre-certification/authorization details such as demographics, insurance/ coverage and clinical information are obtained.
Complete appropriate electronic forms with detailed benefit and pre-certification/ authorization information to ensure a clean claim.
Identifies inaccurate plan codes and corrects in the hospital’s main frame.
Work directly with multiple insurance websites to obtain benefits and authorization validation.
Adheres to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI). You Have:
High School diploma or equivalent.
At least one (1) year of similar experience (patient-facing, patient access).
Excellent customer service skills exhibiting good oral and written communication skills.
Ability to type fast and accurately.
Must be able to communicate effectively and professionally to our patients and physician offices. It would be great if you also have:
Coding/Billing experience We offer: R1 is changing healthcare by infusing operational discipline and proprietary technology in hospital financial processes. We are an industry leader; we are the only independent organization with a comprehensive service and technology offering for hospital revenue cycle management, and we have achieved leading outcomes for our customers.
A strong financial performing, growing organization that will keep you on your toes with new ideas, changes and opportunities to learn and grow in abundance.
A culture of excellence, driving customer success so they can focus on improving patient care and on giving back to the community.
A Total Rewards package which may include such things as: competitive compensation package, the ability to choose from a comprehensive benefit program mostly funded by R1 that includes medical, dental, vision, flexible spending accounts, commuter benefits, life and disability insurance, along with work life balance programs including paid time off for personal time, illness and volunteering, and we offer a retirement savings plan and continuing training and development and so much more! Sound like you? Let’s talk! About R1: R1 is a leading provider of revenue cycle management services and Physician Advisory Services to healthcare providers. We are the largest independent end-to-end revenue cycle provider and have the longest operating history in the revenue cycle industry. R1’s objective is tobethe one trusted partner to manage revenue so providers and patients can focus on what matters most. Our distinctive operating model and values includes people, processes, and sophisticated integrated technology/analytics that help customers realize sustainable improvements in their operating margins and improve the satisfaction of their patients, physicians, and staff. We are dedicated to transforming the commercial infrastructure and patient experience in healthcare. req5058 Category: Operations- Ascension- Crittenton
Hospital Product Sales Representative
Hospital Product Sales Representative
Anacom MedTek, has been a leading manufacturer of Nurse Call Products for over 40 years. Our products lead the field in technology, are the highest quality and competitively priced.
Inside Sales Position
1. Established Territory/Relationship Based Sales
2. Responsible for developing and acquiring new accounts,
as well as maintaining an established territory.
3. Out of State Travel Required - Up to 6/7 weekly trips per year.
4. Unlimited earning potential in commissions.
Qualified candidates will have:
1. At least 3 years of sales experience (medical sales / nurse call systems a plus)
2. Ability to travel to assigned territory on a scheduled basis.
3. Strong organizational skills
4. Excellent communication and people skills
5. Enthusiastic for meeting new people and building lasting relationships
6. Computer literate
7. Must be motivated / goal oriented.
Anacom MedTek offers a competitive compensation package, medical and dental insurance benefits, 401K, Life Insurance and a friendly work environment.
Hospital Refund Representative
At Ethos, we help/service AHMC hospitals on their revenue cycle objectives. The Refund Coordinator is responsible for the accurate and timely review and preparation of refunds (patient and insurance) and for reducing credit balances in a timely and efficient manner.
This position requires the full understanding and active participation in fulfilling the mission of Ethos Management Inc. It is expected that the employee demonstrate behavior consistent with the core values of Ethos Management. The employee is expected to support all organizational expectations including, but not limited to Correspondence, Patient’s Rights, Confidentiality of Information, and Ethos Management initiatives.
A. Maintains productivity of a minimum combined total of 25 refunds (patient and insurance) requests daily and/or a monthly average of 80% or higher.
B. Researches and/or follows-up on the credit balance report for timely preparation of refunds and facility and Senior Management approval.
C. Reviews credit balances for correct payment based on the contractual terms and makes necessary adjustments or corrections while utilizing Med Assets as necessary.
D. Processes the Month End Credit report from facility DPS to verify overpayment(s).
E. Adjusts insurance credit balance accounts >365 days to zero.
F. Resolves cash accounts and/or patient credit balances >180 days in a timely manner.
G. Reviews all related accounts for open balances before generating refunds and documents in quick notes.
H. Follows-up on returned refund checks to ensure proper reimbursement of accounts.
I. Follows-up on uncashed refund checks and verifies if reissue or transfers to unclaimed property as necessary.
J. Responds to all incoming telephone and/or correspondence requests and performs necessary action to ensure timely account resolution.
K. Scans refund request forms and refund checks into CPSI.
L. Ensures all inquiries from patients, facilities, co-workers, and Senior Management are handled professionally, courteously, and in a timely manner.
M. Attends department specific education/training, in-services, and staff meetings.
N. Follows Ethos management procedures for account management protocol.
O. Abides by Ethos Management Inc.’s Code of Conduct and HIPAA compliance.
P. Performs other duties as assigned.
- 1year of recent refund or billing and collection experience in acute hospital or medical office
- Ability to maintain records, balance books, and knowledge of general accounting procedures
- Familiarity with discounted business and hospital contracts preferred
- Proficient with Microsoft Word and Excel applications
- High school diploma or equivalent required
- General Workplace Safety
- General office environment.
- Lighting and temperature are adequate, and there are no hazardous or unpleasant conditions caused by noise, dust, etc.
- Work in generally performed within an office environment, with standard office equipment available.
Insurance Specialist - 40 Hrs Day Shift (Detroit Hospital Campus)
GENERAL SUMMARY: Under general supervision, identifies and determines in accordance with established policies and procedures the accuracy and completeness of financial, insurance and/or demographic information for patients receiving care HFHS.
Accountable and responsible for all pre-admissions, admissions, and specified scheduled outpatient services rendered at HFHS. Investigates and reviews the accuracy and completeness of insurance information upon pre-admission and/or admission to ensure account is secure prior to discharge. Obtains benefit, co-pay, deductible, and co-insurance information.
Verifies insurance eligibility and benefit information and confirms that all insurance requirements are met, including but not limited to referrals and authorizations. Resolves problem accounts to determine primary insurance and/or COB information. PRINCIPLE DUTIES AND RESPONSIBILITIES:
A variety of functions and responsibilities related to insurance verification and identifying authorization requirements prior to and/or after discharge of patient, which includes:Research and review all insurance plans and confirms patient benefit eligibility, including patient liabilities, clauses, riders, and secondary payor information (coordination of benefits) via internal and external resources including contacting payor representatives as needed.Reviews and interprets insurance group pre-certification requirements. Ensures proper pre-authorizations have been obtained. Executes on-line operations for specific payors to complete the pre-certification process.
Communicates data to HFHS Utilization Management Department for further medical review.Resolves discrepancies with the patient and/or family members, employers and insurance companies to assist in obtaining insurance information. Interviews patients and/or family members; advises patient with regards to next steps or processes for securing financial coverage. Reviews and analyzes third party COB screen prior to billing to prevent claims rejection.
Works with patient or family member regarding outstanding COB issues.Reviews, analyzes and corrects COB discrepancies and other related issues to ensure the integrity of the insurance information is accurate prior to discharge.Handles insurance questions and/or obtains information from various HFHS areas including but not limited to clinics, physicians, patients, attorneys, employers and outside agencies via telephone or mail.Prepare and ensures account for accuracy in preparation for billing to third party payors utilizing several different arenas within HFHS computer system as well as other on line systems.Obtains referral from referring physician office, prior to admission, as required by the payor.Maintains status of all accounts pending verification reviews, utilizing applicable work queues, and takes appropriate action to resolve accounts.Represents HFHS to external agencies on issues involving workers compensation, motor vehicle accidents and/or third party liability admissions and issues pertaining to financial policies and procedures.Performs functions necessary to secure referrals/authorizations on applicable encounters, maintaining an appropriate lead-time as established by departmental guidelines.Responsible for referring accounts to the HFHS funding source vendor when an insurance cannot otherwise be secured.Provides World Class Service Excellence to patients:Warm patient greeting and closing. (AIDET)Service Recovery (HEART)Adheres to Chief First Impressions Officer (CFIO) standards.Maintains Front Desk and Lobby Appearances according to policy. EDUCATION/EXPERIENCE REQUIRED:High school diploma or GED equivalent is required.Two (2) years of experience related to healthcare insurance eligibility, insurance verification or insurance billing in a hospital/medical office setting.Knowledge of various insurance coverage, COB rules of priority and processing procedures.Insurance payor systems experience required.EPIC training/experience preferred.ICD-10 medical terminology experience preferred.Ability to adjust to new technologies as introduced.Strong computer skills and working knowledge of Microsoft Office products.Ability to perform a variety of tasks in a fast-paced environment with frequent interruptions. Overview Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education.
The system includes the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory network and many other health-related entities throughout southeast Michigan, providing a full continuum of care. In 2015, Henry Ford provided $299 million in uncompensated care. The health system also is a major economic driver in Michigan and employs more than 24,600 employees.
Henry Ford is a 2011Malcolm Baldrige National Quality Award recipient. The health system is led by President and CEO Wright Lassiter III. To learn more, visit
HenryFord.com. Benefits Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice.
Henry Ford Health System has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life.
As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other benefits and services. Equal Employment Opportunity/Affirmative Action Employer Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.
Outside Sales Representative - Insurance Agent - Insurance Sales
Outside Sales Representative - Insurance Agent
Senior Life Services has offered challenging and rewarding insurance sales opportunities since 1972. With operations in over 20 states, SLS specializes in serving the growing senior market, offering solid insurance protection and top quality service that have made us an insurance industry leader.
SLS is growing and interviewing intelligent, dedicated, outgoing professionals who are interested in a rewarding career in life insurance sales. To help our insurance sales representatives reach their full earnings potential, we offer:
- Competitive compensation packages
- Weekly, Monthly and quarterly bonuses and incentives
- Formal training via our nationally recognized programs
- Management growth opportunities
- Access to free lead generation ($25-50,000 annually!) and prospecting programs
- SOLID support staff
Prior insurance or sales experience is preferred but not required. Coaching is provided to help you succeed.
Apply now and find out how we’ve become the industry leader in final expense life insurance.
SLS is a great place to build your career! APPLY TODAY!
Dr. Ronald Federico
Become a part of our team and experience the rapidly growing senior market. OUR SALES THESE PAST FOUR YEARS HAVE GROWN BY 245% AND THIS YEAR IS GOING TO BE ANOTHER RECORD BREAKING YEAR FOR SENIOR LIFE SERVICES. Come be apart of this growth!
Life Insurance Representative - Life Insurance Agent - NO Cold Calling
We are looking for Licensed and Non-Licensed agents who are goal-oriented and self-motivated. We have a unique sales system and mentoring program. The ability to grow yourself, your business , help others AND make money while you do it, provides for a unique opportunity. There are a few things that set us apart from other IMO's; warm leads, our training and mentoring system and the Equity Bonus program.
THERE IS NO COLD CALLING!! We have access to the highest quality exclusive direct mail leads.
- Each week we mail out thousands of letters to new home buyers or newly refinanced homes. The client will fill out information such as: name, DOB, height and weight, and their phone number that they can be reached at and mail it back in to our company. We are looking for the right person to go meet with these clients and protect their family. We specialize in Mortgage Protection but the agent is able to work with Final Expense, Whole Life, IUL's, and Annuities.
- We ONLY work with the TOP rated insurance companies.
We have an unmatched training and supportsystem in place as well. We will train you and get you going for FREE!!
- There is the ability to build your own agency to create passive income.
IF YOU ARE A PROVEN $20K/MONTH OR MORE PRODUCER, WE WILL CONSIDER A HIGHER STARTING CONTRACT.
You MUST have your insurance license, however, if you do not have it yet we can help you get it. THIS IS A FULL COMMISSION JOB!
- There is the ability to get promoted every 2 months once the qualifications are met.
- The average sale is around $700.
- Full-Time agents should sell at least 5 polices a week, which would be around $3500/wk in sales.
- We will consider the right part-time agent.
If you think this sounds like a possible fit, APPLY NOW!!
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