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Insurance Clerk II

Swope Health
Kansas City, MO
  • Expired: December 10, 2022. Applications are no longer accepted.

Sign on Bonus $1000 for candidates who are selected to be paid in two increments-$500 at hire and $500 after 90 days of employment JOB SUMMARY The Insurance Clerk II is responsible for accounts receivable functions for insurance plans and third party payors, under the guidance of regulatory and contractual requirements. Also, responsible for reviewing changes or updates to regulatory requirements, and working with third party payors to resolve claim issues. PRIMARY FUNCTIONS 1. Prepare and file insurance claims in accordance with insurance carrier's regulatory and contractual requirements. 2.

Review, correct, and reconcile rejections from clearing house or CIMOR system. 3. Review, reconcile, and post remittance advices (RA) or explanations of benefits (EOB) as received for assigned insurance carriers. 4. Process, correct, or adjust denied claims and overpayments for assigned insurance carriers. 5.

Work with other departments to obtain insurance information as needed to file or correct claims for assigned insurance carriers. 6. Review and process open items reports for assigned insurance carriers. 7. Work with insurance plans and third party payors to resolve claim issues for assigned insurance carriers. 8.

Verify Insurance eligibility for scheduled appointments. 9. Process collection of deductibles and co-insurance for insurance carriers assigned. 10. Review insurance bulletins, email updates, and website updates for changes in requirements or processes, and communicate information to Insurance clerks as applicable. 11.

Assist Insurance Clerk I personnel with interpretation of insurance regulations and billing guidelines. 12. Resolve issues in the EDI process with clearinghouse, insurance carrier, or CIMOR (including insurance and site enrollment.) 13. Performs other duties as assigned. QUALIFICATIONS 1.

Two (2) years' experience with insurance accounts receivables or a related field required. 2. High school graduate or G.E.D. 3. Must have experience working with Microsoft Office products and web based insurance programs. 4.

Technical School training preferred. 5. Attention to detail and accuracy is a must.

Swope Health

Address

Kansas City, MO
64126 USA

Industry

Finance and Insurance

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