Prevea Health
Insurance Clerk - Medicare - Green Bay, WI
Prevea Health, Green Bay, Wisconsin, United States, 54311
Insurance Clerk - Medicare
#25-601
Location Green Bay, Wisconsin, United States Tulip Lane-023
Description Insurance Clerk
Come work where we specialize in you! We have nearly 2,000 reasons for you to consider a career with Prevea Health - they're our employees. We're an organization that values kindness, responsibility, inclusivity, wellness and inspiration. At Prevea, we provide continuous education, training and support so every member of the team contributes to our success. Together we are the best place to get care and the best place to give care.
Job Summary The Insurance Clerk is responsible for supporting Prevea Health's revenue cycle by resolving commercial insurance denials, monitoring aged receivables, and following up with insurance carriers to ensure timely and accurate reimbursement. This role requires providing exceptional care to our patients and demonstrating respect and collaboration with co-workers. The Insurance Clerk must maintain a high level of performance, communicate positively and professionally, and prioritize patient needs while performing all responsibilities efficiently.
What you will do
Respond and investigate denials by insurance carrier. Draft appeal letters, as necessary.
Follow-up on improperly paid claims.
Monitor aged receivables for Medicare insurance bill types and follow-up with insurance carriers.
Work problem accounts and resolve them in satisfactory manner.
Answer patient account questions by phone in a professional, tactful and friendly manner, communicates on a need to know basis.
Reviewing and following up on improperly paid claims
Drafting appeals/letters to get claims paid
Attends required meetings and participates in committees as requested.
Education Qualifications
High School Diploma and/or GED Required
Experience Qualifications
1-3 years Minimum 2-3 years experience in an insurance or health care setting. Required
Previous experience in customer service. Required
Experience with computers and Windows based applications. Required
Skills and Abilities
Strong knowledge of commercial insurance billing policies and procedures, including CPT/ICD-9 codes, usual and customary charges, and confidentiality requirements.
Ability to work independently and collaboratively while performing responsibilities efficiently and accurately
Strong investigative, problem-solving, and analytical skills.
Proficiency in computer applications, including Windows, Excel, Word, and 10-key data entry.
Excellent organizational, time management, and communication skills, both written and verbal, with internal and external customers.
Licenses and Certifications
Certification in medical billing or coding (e.g., CPC, CCA) Preferred
Physical Demands
Sit - Constantly
Stand - Occasionally
Walk - Occasionally
Drive - Rarely
Climb (Stairs/Ladders) - Rarely
Bend (Neck) - Frequently
Gross Manipulation (Hands/Arms) - Frequently
Squat - Occasionally
Kneel/Crawl - Rarely
Twist/Turn (Neck) - Frequently
Twist/Turn(Waist) - Occasionally
Lift/Carry 0-10 lbs. - Frequently
Lift/Carry 11-25 lbs. - Occasionally
Lift/Carry 26-35 lbs. - Occasionally
Lift/Carry 36-50 lbs. - Rarely
Push/Pull 11-25 lbs. - Rarely
Push/Pull 26-35 lbs. - Rarely
Push/Pull 36-50 lbs. - Rarely
Reach (Above shoulder level) - Rarely
Reach (Below shoulder level) - Constantly
Simple Grasping (Hands/Arms) - Constantly
Fine Manipulation (Hands/Arms) - Constantly
Gross Manipulation (Hands/Arms) - Frequently
Working Conditions
Noise - Occasionally
Travel Requirements
5%
Hearing Requirements
Hears Whispers
Hears Whispers 3-8 feet - Constantly
Vision Requirements
Color Discrimination - Constantly
Near Vision (Correctable to Jaeger 2 or 20/40 binocular) - Constantly
Distance Vision (Correctable to Snellen chart 20/40 binocular) - Constantly
Prevea is an Equal Employment Opportunity/Affirmative Action employer. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire. Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify
Position Located In Green Bay,WI
#J-18808-Ljbffr
Location Green Bay, Wisconsin, United States Tulip Lane-023
Description Insurance Clerk
Come work where we specialize in you! We have nearly 2,000 reasons for you to consider a career with Prevea Health - they're our employees. We're an organization that values kindness, responsibility, inclusivity, wellness and inspiration. At Prevea, we provide continuous education, training and support so every member of the team contributes to our success. Together we are the best place to get care and the best place to give care.
Job Summary The Insurance Clerk is responsible for supporting Prevea Health's revenue cycle by resolving commercial insurance denials, monitoring aged receivables, and following up with insurance carriers to ensure timely and accurate reimbursement. This role requires providing exceptional care to our patients and demonstrating respect and collaboration with co-workers. The Insurance Clerk must maintain a high level of performance, communicate positively and professionally, and prioritize patient needs while performing all responsibilities efficiently.
What you will do
Respond and investigate denials by insurance carrier. Draft appeal letters, as necessary.
Follow-up on improperly paid claims.
Monitor aged receivables for Medicare insurance bill types and follow-up with insurance carriers.
Work problem accounts and resolve them in satisfactory manner.
Answer patient account questions by phone in a professional, tactful and friendly manner, communicates on a need to know basis.
Reviewing and following up on improperly paid claims
Drafting appeals/letters to get claims paid
Attends required meetings and participates in committees as requested.
Education Qualifications
High School Diploma and/or GED Required
Experience Qualifications
1-3 years Minimum 2-3 years experience in an insurance or health care setting. Required
Previous experience in customer service. Required
Experience with computers and Windows based applications. Required
Skills and Abilities
Strong knowledge of commercial insurance billing policies and procedures, including CPT/ICD-9 codes, usual and customary charges, and confidentiality requirements.
Ability to work independently and collaboratively while performing responsibilities efficiently and accurately
Strong investigative, problem-solving, and analytical skills.
Proficiency in computer applications, including Windows, Excel, Word, and 10-key data entry.
Excellent organizational, time management, and communication skills, both written and verbal, with internal and external customers.
Licenses and Certifications
Certification in medical billing or coding (e.g., CPC, CCA) Preferred
Physical Demands
Sit - Constantly
Stand - Occasionally
Walk - Occasionally
Drive - Rarely
Climb (Stairs/Ladders) - Rarely
Bend (Neck) - Frequently
Gross Manipulation (Hands/Arms) - Frequently
Squat - Occasionally
Kneel/Crawl - Rarely
Twist/Turn (Neck) - Frequently
Twist/Turn(Waist) - Occasionally
Lift/Carry 0-10 lbs. - Frequently
Lift/Carry 11-25 lbs. - Occasionally
Lift/Carry 26-35 lbs. - Occasionally
Lift/Carry 36-50 lbs. - Rarely
Push/Pull 11-25 lbs. - Rarely
Push/Pull 26-35 lbs. - Rarely
Push/Pull 36-50 lbs. - Rarely
Reach (Above shoulder level) - Rarely
Reach (Below shoulder level) - Constantly
Simple Grasping (Hands/Arms) - Constantly
Fine Manipulation (Hands/Arms) - Constantly
Gross Manipulation (Hands/Arms) - Frequently
Working Conditions
Noise - Occasionally
Travel Requirements
5%
Hearing Requirements
Hears Whispers
Hears Whispers 3-8 feet - Constantly
Vision Requirements
Color Discrimination - Constantly
Near Vision (Correctable to Jaeger 2 or 20/40 binocular) - Constantly
Distance Vision (Correctable to Snellen chart 20/40 binocular) - Constantly
Prevea is an Equal Employment Opportunity/Affirmative Action employer. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire. Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify
Position Located In Green Bay,WI
#J-18808-Ljbffr