Insurance Representative - EQUIP - Remote MN, ND, SD

Sanford Health; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

Sanford Health is seeking an Insurance Representative for a remote position. The role involves processing insurance claims, ensuring compliance with regulations, and handling account follow-ups. Ideal candidates will have strong computer skills and relevant experience, with opportunities for career advancement within the organization.

Qualifications

• Requires six months of related work experience.
• Essential computer skills are necessary.
• Preferred educational background includes post-secondary or trade courses.

Responsibilities

• Processes and monitors unpaid third party insurance and government accounts.
• Prepares claims to payers and secures necessary medical documentation.
• Identifies and resolves insurance balance issues.

Skills

Computer skills

Education

High school diploma or equivalent

Post-secondary courses in accounting, business, and communications

Job description

Insurance Representative - EQUIP - Remote MN, ND, SD

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Work Shift:

Scheduled Weekly Hours:

40Salary Range: $16.00 - $23.00

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Work Shift:

Scheduled Weekly Hours:

40Salary Range: $16.00 - $23.00

Union Position:

No

Department Details

Summary

The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement.

Job Description

Must understand and be able to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Proactively identifies and performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials. Uses advanced knowledge and understanding to process payer rejections. Conducts trend analyses, appeals and resolves low payment or underpaid accounts. Provides input for payer-specific meetings. Handles difficult account situations and resolves issues delaying or preventing payments from payers. Performs miscellaneous job related duties as requested.

Consistently demonstrates accuracy in correcting (identified through pre-edits) and submitting claims to payers. Ensures accounts are billed in timely manner. Consistently reports to a manager any accounts that cannot be finished in a timely manner. When claims are disputed, consistently utilizes the correct resources to ensure the completion of the claim. Accurately and completely follows claim through entire billing process. Ensures all claims consistently meet compliance regulations. Demonstrates accountability by consistently using appropriate resources and channels to problem solve issues.

Consistently demonstrates ability to input data accurately into the computer system. Consistently answers the telephone courteously. Maintains and updates computer skills as needed for work assignments. Demonstrates the ability to utilize software applications for maximum efficiency. Consistently ensures verbal communication is courteous, complete, and professional whether using phone or personal contact. Consistently ensures written communication is accurate, complete and professional in presentation whether word processing or using email. Identifies and promptly resolves billing complaints. Directs issues to supervisor when unable to resolve. Documents in computer system all contacts regarding patient accounts.

Depending on location, may verify demographics, identify appropriate third-party insurance/payers, set up insurance, initiate patient financial assistance. Contact the insured or financially responsible party to obtain missing information. Verify, create or update patient accounts for billing, prepare insurance claims forms or related documents, and verify completeness and accuracy.

Qualifications

High school diploma or equivalent preferred; post-secondary or trade courses in accounting, business, and communications would be helpful for this position.

Six months' related work experience required. Computer skills essential. When applicable and if desired, leadership may require related experience to the Associate Insurance Representative at Sanford Health for internal applicants.

Sanford is an EEO/AA Employer M/F/Disability/Vet.

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to [e-mail].

About the company

Sanford Health, one of the largest health systems in the US, is dedicated to the delivery of health care, genomic medicine, senior care and services, global clinics, research and affordable insurance. Sanford Health Jobs

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