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Senior Insurance Representative - AF - PFS Billing - Hospital

Employer
Sanford Health
Location
Bemidji, Minnesota
Salary
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Job Details


Job Title: Senior Insurance Representative - AF | PFS Billing - Hospital | Bemidji

City: Bemidji

State: MN

Department *: * PFS Billing - Hospital

Job Schedule: Full Time

Shift: Days

Hours Per Shift: 8 hr

JOB SUMMARY

The Senior Insurance Representative will be expected to process and monitor unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement. Must understand and be able to work accounts in all areas of the revenue cycle. Expected duties include but are not limited to: Preparing and submitting claims to payers either electronically or by paper. Securing needed medical documentation required or requested by payers.Monitoring and tracking contractual, billing, and posting errors and provide continuous feedback to Supervisor. Performing account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Completing work within authorized time to assure compliance with departmental standards. Keeping updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understanding edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processing and resolve complex denials. Processing and resolve high dollar claim issues. Must be accessible to other departments upon demand for inquiries. Advanced knowledge and understanding to process payer rejections. Trending analysis, appeals and resolves low payment or underpaid accounts. Providing input for payer specific meetings. Dealing with difficult account situations and resolve issues delaying/preventing payments from payers. Analyzing and review accounts to identify procedural inefficiencies and recommend improvements. Performs miscellaneous job related duties as requested. Must be knowledgeable of the billing requirements of third party payers. Possess a basic understanding of medical terminology as well as ICD-9, CPT coding, and good working knowledge of general business procedures, accounting principles, and computer programs.

QUALIFICATIONS

Post secondary education or equivalent training in a health care or business related field is required; Associate's degree preferred. Must have at least three years of applicable experience, with previous experience in a healthcare setting preferred.

About Sanford Health:

At Sanford Health, we are dedicated to the work of health and healing.
Every day, we show that commitment by delivering the highest quality of care to the communities we serve.
We are leaders in health care and strive to provide patients across the region with convenient access to expert medical care, leading-edge technologies and world-class facilities.
In addition to strong clinical care, we are also committed to research, education and community growth.
We engage in medical research to not only discover innovative ways to provide care, but also cures for common diseases.
We continuously seek new ways to achieve our vision of improving the human condition here in your community, across the region and around the world.
The entire team at Sanford Health recognizes the value of healthy families and communities.
We continue to gain momentum and expand our reach. Together, we can make a positive difference now, and in the future.
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 talent@sanfordhealth.org .

City: Bemidji

State: MN

Job Function: Revenue Cycle

Job Schedule: Full Time

Shift: Days

Req Number: WD11004

Company

Sanford Health is excited to be on a journey of tremendous growth and momentum. With our vast geography, cutting-edge medicine, sophisticated research, advanced education and our own health plan, we are unique in what we do and how we do it. Through relationships built on trust and successful performance and a vision to improve the human condition, Sanford seeks to make a significant impact on health and healing. With a commitment to diversity and inclusion, our journey as an organization includes continually building on the diverse talents, experiences and beliefs of our employees, as well as the patients and communities we serve. We are proud to be from the Midwest and to impact the world. We look forward to joining with you in the journey.

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