Insurance Clerk Job Description

Insurance Clerk Job Description

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Insurance clerk provides technical assistance to producers and account managers regarding policy forms and endorsements, rating plans, and risk retentions options.

Insurance Clerk Duties & Responsibilities

To write an effective insurance clerk job description, begin by listing detailed duties, responsibilities and expectations. We have included insurance clerk job description templates that you can modify and use.

Sample responsibilities for this position include:

Provides information regarding products and services, such as components of MIC coverages that are in existing policies
Review mortgage information on appropriate systems
Update system files as required
Assist in training new staff members on procedures and guidelines
Contacting carriers regarding reduced or denied reimbursement and ensuring patient insurance information is accurate
Retrieving medical documentation and developing, submitting, and tracking appeals to carriers, per department procedure
Reviewing and analyzing all incoming explanation of benefits and adjusting patient' accounts to reflect the carrier decisions on patient statements
Assist Underwriting Teams
For insuring the timely resolution of accounts receivables from insurance and other non-patient payors
Daily account follow-up

Insurance Clerk Qualifications

Qualifications for a job description may include education, certification, and experience.

Education for Insurance Clerk

Typically a job would require a certain level of education.

Employers hiring for the insurance clerk job most commonly would prefer for their future employee to have a relevant degree such as High School and Collage Degree in Associates, Technical, Finance, Accounting, Education, General Education, Business, Computer, Administration, Communication

Skills for Insurance Clerk

Desired skills for insurance clerk include:

ISO and manuscript insurance forms and endorsements
Health Plans and IPA’s
Commercial Lines procedures
Company rate deviations
Dividend plans
Rating plans
Coverages
Policy forms
Rating plans and manuals for all binding authority lines written
Collections policies and procedures and the Fair Debt Collection Practices Act

Desired experience for insurance clerk includes:

Review, research and reconcile escrow and non-escrow reports from Core Logic regarding delinquent taxes, liens and set-up issues
Review weekly open items report and communicate with insurance company and third party insurance tracking company on accounts we have not received policies
Verifies all insurance information including authorizations, benefits coverage, electronic payer ID# and claims mailing address
Reviews and corrects all insurance information in the Patient Accounting System, including but not limited to any deductible, co-payment or patient payments that need to be collected at the time of service
Informs patients and Pre-Admission Clerk of any deductible, co-payment or patient payments
Provide back-up support for business office staff

Insurance Clerk Examples

1

Insurance Clerk Job Description

Job Description Example
Our growing company is searching for experienced candidates for the position of insurance clerk. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for insurance clerk
  • Prepares policy files for processing
  • Reviews policy applications, forms and supporting documentation for completeness and accuracy
  • Responsible for data entry and processing standard policy and claim requests by following standard screens and procedures to perform tasks
  • Corrects system errors
  • Resolves routine questions and problems, refers more difficult to higher levels
  • Completes team-s administrative support duties
  • Follows standard procedures and guidelines
  • Prepare statistic report for management
  • Open mail, separate, scan and route to appropriate bin
  • Prepare and index daily correspondence
Qualifications for insurance clerk
  • Meets productivity and QA standards
  • Processes orders, prepares correspondence, and fulfills customer needs to ensure customer satisfaction
  • Works collaboratively with others, shares best practices, and assists teammates with work
  • Analytical ability and good judgment in evaluating Statement of Health submissions
  • Work with confidential files
  • Must have experience working with Michigan Medicaid
2

Insurance Clerk Job Description

Job Description Example
Our innovative and growing company is hiring for an insurance clerk. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for insurance clerk
  • Must be able to work well with company personnel, Vendors, and Outside Insurance Agents on a daily basis to collect the outstanding items
  • Obtains authorizations in a timely manner
  • Receives MD order and coverage authorization from agency designee
  • Requests authorization from insurance company case manager to provide specific services and parameters of care
  • Negotiate rates with insurance provider if out-of-network
  • Determine plan eligibility and enroll members within CMS regulatory guidelines
  • Work toward maintaining the current member database by correcting/completing applications by using given support tools
  • Process plan changes, cancellations, terminations and involuntary dis-enrollments within the CMS regulatory guidelines
  • Maintain member demographic update and membership re-validation and apply eligibility requirements for membership changes
  • Research and respond to eligibility inquiries by working within the company systems
Qualifications for insurance clerk
  • Experience with insurance verification and surgery scheduling
  • Years of insurance authorization experience preferred
  • Experience in the health care billing industry, preferred
  • Utilization management experience and pre-certification helpful
  • Knowledge of insurance policies for home care authorizations
  • Ability to establish and maintain effective working relationships with all segments of the branch staff, billing and collections department and, insurance representatives
3

Insurance Clerk Job Description

Job Description Example
Our company is searching for experienced candidates for the position of insurance clerk. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for insurance clerk
  • Support the all aspects of the Annual Enrollment process as taught during training
  • Verify that sufficient information is available for accurate verification and eligibility
  • Obtain authorizations from insurance companies/physician offices
  • Be familiar with individual payer guidelines and the process of collecting over the counter payments/deductibles/co-pay/co-insurance
  • Contacting insurance companies via phone or website to confirm coverage
  • Updating and maintaining patient insurance information
  • Adhering to all HIPAA and company regulations, policies, and procedures
  • Posting and mailing of refund checks to patient accounts
  • Review accounts to ensure accuracy of information
  • Review/approve refund requests
Qualifications for insurance clerk
  • Usage of Medical Terminology
  • Computer literate and can learn new software programs
  • Can use basic office equipment
  • Computer literate and with a high rate of accuracy important
  • Mandatory overtime a must
  • Must be able to work 6 am - 6 pm Mondays through Fridays with some Saturdays
4

Insurance Clerk Job Description

Job Description Example
Our company is looking to fill the role of insurance clerk. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for insurance clerk
  • Meet deadlines as appropriate with tasks
  • Work closely with the A/P dept
  • Work closely with dental office managers regarding refunds
  • Answer emails related to patient and insurance refunds
  • Process expired/returned refund checks
  • Batch and stage documents
  • Apply identifiers for multi-page documents with attachments
  • Label non-scannable /miscellaneous documents
  • Load documents into buckets ID and route miscellaneous non-scannable documents
  • Generate correspondence on return documents
Qualifications for insurance clerk
  • Must have excellent computer skills and literacy with web site navigation
  • Must have comprehension of contracts and benefits
  • Must be comfortable explaining financial liabilities/responsibilities to patients prior to scheduled surgeries
  • Qualifications include 8,000 plus keystrokes per hour, with 3 or less error rate
  • Windows knowledge/ability to work within multiple systems
  • Comfortable with Microsoft Office and Outlook
5

Insurance Clerk Job Description

Job Description Example
Our company is growing rapidly and is looking to fill the role of insurance clerk. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for insurance clerk
  • Any special projects as assigned by management
  • Meet the production and quality goals of the department
  • Overtime may be required as needed
  • Batch and log claims and appeals
  • Attach applicable documentation to correspondence and misdirected claims
  • Handle Mailings appropriately and timely
  • Assist with scanning and outsource process including reconciling files and batching rejected claims
  • Ensure documents are issued to Brokers in a timely manner
  • Ensure policy details are correct with regard to risk / premium / cover
  • Assist team members with various tasks & duties
Qualifications for insurance clerk
  • Excellent attendance is required along with a professional demeanor
  • 1-2 years professional loan insurance-related experience preferred but not required
  • Active knowledge of CMS guidelines contracted insurance guidelines and coding policies
  • Ability to establish and maintain effective working relationship with team members, clinic staff, payers and patients
  • Have a desire and dedication to work with self-discipline
  • Typing Skills (will be tested)

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