Insurance Clerk - Medicare at Prevea Health

Howard, Wisconsin, United States -

Full Time

Start Date

Immediate

Expiry Date

30 Mar, 26

Salary

0.0

Posted On

30 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Billing, Customer Service, Problem-Solving, Analytical Skills, Communication Skills, Organizational Skills, Time Management, CPT Codes, ICD-9 Codes, Windows Applications, Excel, Word, Data Entry, Collaboration, Investigative Skills, Confidentiality

Industry

Hospitals and Health Care

Description

Insurance Clerk -------------------------------------------------------------------------------- Come work where we specialize in you! We have nearly 2,000 reasons for you to consider a career with Prevea Health—they're our employees. We're an organization that values kindness, responsibility, inclusivity, wellness and inspiration. At Prevea, we provide continuous education, training and support so every member of the team contributes to our success. Together we are the best place to get care and the best place to give care. Job Summary The Insurance Clerk is responsible for supporting Prevea Health's revenue cycle by resolving commercial insurance denials, monitoring aged receivables, and following up with insurance carriers to ensure timely and accurate reimbursement. This role requires providing exceptional care to our patients and demonstrating respect and collaboration with co-workers. The Insurance Clerk must maintain a high level of performance, communicate positively and professionally, and prioritize patient needs while performing all responsibilities efficiently. What you will do * What you will do * Respond and investigate denials by insurance carrier. Draft appeal letters, as necessary. * Follow-up on improperly paid claims. * Monitor aged receivables for Medicare insurance bill types and follow-up with insurance carriers. * Work problem accounts and resolve them in satisfactory manner. * Answer patient account questions by phone in a professional, tactful and friendly manner, communicates on a need to know basis. * Reviewing and following up on improperly paid claims * Drafting appeals/letters to get claims paid * Attends required meetings and participates in committees as requested. Education Qualifications * High School Diploma and/or GED Required Experience Qualifications * 1-3 years Minimum 2-3 years experience in an insurance or health care setting. Required * Previous experience in customer service. Required * Experience with computers and Windows based applications. Required Skills and Abilities * Strong knowledge of commercial insurance billing policies and procedures, including CPT/ICD-9 codes, usual and customary charges, and confidentiality requirements. * Ability to work independently and collaboratively while performing responsibilities efficiently and accurately * Strong investigative, problem-solving, and analytical skills. * Proficiency in computer applications, including Windows, Excel, Word, and 10-key data entry. * Excellent organizational, time management, and communication skills, both written and verbal, with internal and external customers. Licenses and Certifications * Certification in medical billing or coding (e.g., CPC, CCA) Preferred Physical Demands * Sit - Constantly * Stand - Occasionally * Walk - Occasionally * Drive - Rarely * Climb (Stairs/Ladders) - Rarely * Bend (Neck) - Frequently * Gross Manipulation (Hands/Arms) - Frequently * Squat - Occasionally * Kneel/Crawl - Rarely * Twist/Turn (Neck) - Frequently * Twist/Turn(Waist) - Occasionally * Lift/Carry 0-10 lbs. - Frequently * Lift/Carry 11-25 lbs. - Occasionally * Lift/Carry 26-35 lbs. - Occasionally * Lift/Carry 36-50 lbs. - Rarely * Push/Pull 11-25 lbs. - Rarely * Push/Pull 26-35 lbs. - Rarely * Push/Pull 36-50 lbs. - Rarely * Reach (Above shoulder level) - Rarely * Reach (Below shoulder level) - Constantly * Simple Grasping (Hands/Arms) - Constantly * Fine Manipulation (Hands/Arms) - Constantly * Gross Manipulation (Hands/Arms) - Frequently Working Conditions * Noise - Occasionally Travel Requirements * 5% Hearing Requirements * Hears Whispers < 3 feet - Constantly * Hears Whispers 3-8 feet - Constantly Vision Requirements * Color Discrimination - Constantly * Near Vision (Correctable to Jaeger 2 or 20/40 binocular) - Constantly * Distance Vision (Correctable to Snellen chart 20/40 binocular) - Constantly Prevea is an Equal Employment Opportunity/Affirmative Action employer. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire. Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify

Responsibilities

The Insurance Clerk is responsible for resolving commercial insurance denials and monitoring aged receivables to ensure timely reimbursement. This role also involves answering patient account questions and drafting appeal letters as necessary.