Third-Party Insurance Representative

Job Title: Third-Party Insurance Representative

Location: Melville, NY

Salary: $21 - $26 per hour

Job Description:

As a Third-Party Insurance Representative at our Health Network located in Melville, NY, you will play a vital role in ensuring smooth and efficient processing of insurance claims and payments. You will be responsible for communicating with various third-party insurance providers to verify coverage, resolve billing discrepancies, and facilitate timely reimbursement for medical services provided by our network.

Key Responsibilities:

1. Insurance Verification: Verify insurance coverage and benefits for patients, ensuring accuracy and completeness of information.

2. Claims Processing: Submit and process insurance claims electronically or through manual submission methods, following established guidelines and protocols.

3. Billing Resolution: Investigate and resolve billing discrepancies or denials with third-party insurance companies, including appeals and resubmissions when necessary.

4. Patient Communication: Communicate with patients regarding insurance coverage, billing inquiries, and payment options, providing clear and accurate information to address their concerns.

5. Documentation: Maintain detailed records of insurance verification, claims submissions, payments, and correspondence with insurance providers for auditing and reporting purposes.

6. Adherence to Regulations: Stay updated on healthcare insurance regulations, policies, and procedures to ensure compliance with state and federal laws governing insurance billing practices.

Qualifications:

• Previous experience in healthcare insurance verification, billing, or related field preferred.
• Strong understanding of medical terminology, insurance terminology, and billing processes.
• Excellent communication and interpersonal skills, with the ability to interact effectively with patients, insurance providers, and internal stakeholders.
• Proficiency in using computerized billing systems and software applications.
• Attention to detail and accuracy in data entry and record-keeping.
• Ability to multitask and prioritize tasks in a fast-paced environment.

Benefits:

• Competitive hourly wage ($21 - $26 per hour).
• Comprehensive benefits package, including medical, dental, and vision insurance.
• Paid time off (PTO) and holidays.
• Opportunities for professional development and career advancement within the organization.