Job Description

The Insurance Plan Clerk, will be working to ensure that reinstatements, modifications, and cancellations of insurance policies are timely and accurately updated in the necessary databases. You will have an important role in determining the patient’s insurance status and extent of insurance benefits, ensuring an efficient billing process for medical providers.

Responsibilities

• Patient accounts for accuracy before placement to outside collection vendors
• Receive account change requests and review required changes.
• Update insurance plan changes on customer accounts.
• Review account information and update required information, balances, etc. / Review the account information to update the balance based on documentation received.
• Research and respond to vendor inquiries (when documentation is required)
• Reviews correspondence in the CWF HPF OnBase system and takes appropriate account and document action
• Reviews and authorizes affidavits related to patient billing, as applicable.
• Ensures vendor inventories reconcile to SSC systems by completing recons and updating I-Plans and/or placements as needed by the end of each month.
• Assists with the Medicaid Eligibility vendor reconciliation, as requested. Manages the onboarding and termination process for vendors
• Provides support during vendor transitions: Medicaid Eligibility, Early Out, Primary and Secondary agencies.
• Handles eRequest and correspondence from collection agencies.
• Responds to requests which include research payments, contractual, approving arrangements, audits, etc.
• Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”
• Other duties as assigned

Skills and Experience

• English – Spanish Language (Oral and written, 85% or higher) (B2+ or above).

• Must have a high school diploma.

• At least 6 months of experience in Data Entry or Customer Service positions.

• The resource will adjust its local schedule with the resources supporting this position during Daylight Saving Time changes in the Eastern Time Zone.

• I have a genuine interest in working with and helping customers.

• Demonstrated experience in providing high levels of customer satisfaction and performance in a high transaction volume/high demand environment preferred.

• Good presentation and a polite, tactful, and friendly character.

• Healthcare experience is a plus

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