Insurance Representative Job Description

Insurance Representative Job Description

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Insurance representative provides accounting support requiring familiarity with and experience in accounting office practices as well as knowledge of a variety of accounting classifications.

Insurance Representative Duties & Responsibilities

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

Sample responsibilities for this position include:

Create insurance plans in company billing system
Edit existing Insurance plans in billing system to increase accuracy
Confirm correct claims address by accessing payer website
Research all returned mail from payers and update billing system accordingly
Periodically generate reports to identify and modify incorrect insurance plan data
Maintain payor information in CareVoyant and Isynergy
Contact contracted payors for demographic updates
Assists Contract Manager in contract information maintenance on existing contracted payors
Enroll users for insurance web portals for claims and eligibility
Maintain CareVoyant Real Time capability by setting up eligible payors in CareVoyant

Insurance Representative Qualifications

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

Licensing or Certifications for Insurance Representative

List any licenses or certifications required by the position: CSS, ACC, I-CAR

Education for Insurance Representative

Typically a job would require a certain level of education.

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

Skills for Insurance Representative

Desired skills for insurance representative include:

Bookkeeping
CPT and ICD9 codes
Basic accounting
Familiarity with insurance industry practices
Medical terminology
Insurance industry practices
Managed care principles
Microsoft Office Suite
Administrative procedures and software applications
Basic accounting and familiarity with medical billing and medical insurance industry practices

Desired experience for insurance representative includes:

Updates contracted payor fee schedule
Seeks clarification of administrative, operational or systems issues
Demonstrates the ability to function in, and contribute to, the team environment
Routinely works a forty (40) hour work week as scheduled and maintains organized work areas
Assist students with annual online enrollment / waiver process
Demonstrated cross-cultural competence

Insurance Representative Examples

1

Insurance Representative Job Description

Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of insurance representative. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for insurance representative
  • Re-submit claims to government agencies, medical service bureaus and insurance companies ensuring that accounts are billed appropriately
  • Service all insurance accounts in order to maintain business
  • Assisting supervisory and non-supervisory employees with various administrative support tasks
  • The work performed by these employees is predominately general administrative in nature, as opposed to specific administrative tasks that are directly related to a specialty functions , marketing, engineering, human resources
  • Applies developed knowledge of the job skills, company policies and procedures to complete a wide variety of difficult assignments/tasks
  • Works on assignments that are moderately complex in nature and require ordinary problem resolution and independent judgment
  • Works under limited supervision and normally receives no instructions on routine work and general instructions given for new assignments
  • Following up with insurance carriers for information
  • Maintaining the book of business by calling on pending cancellations, renewals
  • Provide clerical and member service support to the field sales team
Qualifications for insurance representative
  • Successful completion of a full 4-year course of study in an accredited college or university leading to a bachelor's or higher degree in related/relevant field, , health administration, college student personnel
  • Commitment to a scheduled environment
  • Currently recruiting for Full Time shifts
  • Minimum 1 year of Call Center/Customer service experience
  • Position may include Saturday as a regular work day, with ONE day off during the week (either Tue, Wed, Thu)
  • Healthcare operating system experience including data entry, record look-up and viewing
2

Insurance Representative Job Description

Job Description Example
Our company is hiring for an insurance representative. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for insurance representative
  • Responsible for resolving customer incidents on the telephone using various software tools
  • Will escalate certain incidents to higher levels appropriately using various software tools
  • Ready to work fulltime in an inbound call center environment
  • Will perform other duties/tasks as assigned
  • This is a limited term employee position
  • Answer provider calls and assist them with billing questions using reference manuals, reports, and online
  • Interview patients and completes all paperwork necessary to ensure the admitting process is efficient and all clinic and regulatory policies are in compliance
  • Notifies patient of his/her financial responsibility for services to be provided
  • Accurately and timely post private payments, insurance payments, disallows and/or denials to appropriate patient account, calculate patient responsibility, interpret explanation of benefit message codes
  • Re-submit claims to government agencies, medical service bureaus, and insurance companies ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data, and patient information submitted
Qualifications for insurance representative
  • Ability to make decisions quickly by balancing company guidelines and customer needs
  • Basic PC knowledge and expertise
  • Demonstrated ability to multi-task and meet assigned deadlines
  • Ability to provide effective feedback
  • Exception Processing experience, Attention to detail, Good communication skills
  • Minimum Six (6) months customer service/insurance servicing experience or equivalent education/training required
3

Insurance Representative Job Description

Job Description Example
Our growing company is hiring for an insurance representative. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for insurance representative
  • Completes complex tasks and defined processes
  • Coordination of benefits with other insurance for claims adjudication
  • Manage inbox – Incoming tickets, preliminary and post QC review, assignment
  • Queue Management in compliance with Service Level Agreements
  • Work with technical and business teams
  • Manage System Notifications - Information, critical, or an outage
  • Knowledge Management – Information looping back from ticket resolutions into the knowledge base
  • Call Center role (will be on the phone for this role)
  • Modify policies at loan level by following established guidelines and utilizing internal tracking system to update information as required and contribute to routine documentation processing workflows
  • Resolve information gaps by contacting carriers and agencies as required to gather policy information and other missing data and update systems and records as appropriate
Qualifications for insurance representative
  • Previous collections, call center experience preferred
  • Must be an effective communicator with strong Interpersonal skills necessary to promote a cooperative team environment, provide good customer service and negotiate with insurance companies as needed
  • Ability to perform basic arithmetic calculations in order to perform duties described above
  • Experience following established procedures to complete processing tasks
  • Basic knowledge of data entry processes and procedures
  • Analyze data on a problem-to-problem solution
4

Insurance Representative Job Description

Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of insurance representative. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for insurance representative
  • Complete high volume of data entry by quickly and accurately processing loan-related task queues to meet productivity and quality requirements
  • Manage individual performance by setting work-related goals, tracking personal achievements and communicating with management to report on success and identify improvement strategies
  • Build insurance servicing skills and knowledge by soliciting performance feedback, participating in cross-training and learning additional processes and procedures to support multiple workflows and contribute to effectiveness of team operations
  • Support QBE values in personal work behaviors, decision-making, contributions and interpersonal interactions
  • Part time position working 20 hours per week
  • Handle calls from members and employers
  • Will assist the prior authorization department with multiple programs
  • Some work may include interaction with the client
  • Will handle multiple task as needed to help the department move forward
  • Complies with contract requirements, business unit rules and related industry and legal regulation
Qualifications for insurance representative
  • Previous experience in insurance customer service with personal auto, commercial, motorcycle, recreational vehicle, accident and health, supplemental health, and/or homeowners products
  • Minimum of two years experience processing enrollment applications, or performing medical billing/administrative tasks
  • Ability to work with details and follow directions
  • Ability to use multiple window based screens to perform work
  • At least three years of insurance verification experience preferred
  • A current Claims Adjuster Licenses is a plus
5

Insurance Representative Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of insurance representative. 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 representative
  • Resolve third party denials through appropriate research of carrier specific billing guidelines and through validation of correct billing information being submitted
  • Appeal claims that have either been denied or paid incorrectly either via phone, on-line or in writing dependent on the unique requirements of the payer
  • Respond to communication from third-party payers with requests for information or follow-up
  • Collect and review medical documentation on unpaid claims to ensure compliance with Federal and State billing guidelines
  • Re-submit claims to third party payers ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data, and patient information submitted
  • Conducts detailed research and provides a clear description of findings
  • Uses professional writing abilities for client communication and State publications
  • Completes work assignments beyond a general support level
  • Manages tasks and assignments without detailed direction
  • Identifies, prioritizes and resolves issues independently, and escalates more complex questions or issues as appropriate
Qualifications for insurance representative
  • Experience working in a sales environment preferred
  • A successful candidate will have excellent communication and interpersonal skills, superior organizational skills and a commitment to maintaining superior customer relationships
  • This job requires excellent attendance track record
  • Computer proficiency in Windows-Based Applications
  • Excellent fluency in the language to be supported
  • Experience in a phone based role is preferred

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