Credit Representative
Altru Health

Job Info

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Location:
Altru Patient Services | 3065 Demers

3065 Demers AveGrand Forks, ND 58201

Pay Range: $17.07 - $25.60

Summary:
The Insurance Representative assists patients with inquiries for the clinic and hospital billing system and reviews and submits insurance claims. The Representative processes and monitors insurance unpaid third-party insurance. Must understand and be able to work account throughout the entire revenue cycle, ensuring proper payment is made. Secures necessary medical documentation require or requested by payers. This position tracks pending and unpaid claims and works credit balances and payment work queues.

Essential Job Functions:

• Reviews and monitors insurance unpaid third party insurance and denials to ensure proper payment.
  
• Keeps up to date on all state/federal billing requirements and updates proper departments to ensure all processes are updated accordingly.
  
• Reviews, edits, prepares and submits insurance claims to the appropriate party.
  
• Assists patients with their written, telephone or in person inquiries for the clinic and hospital billing system.
  
• Tracks pending eligibilities and unpaid claims from the work queue. Works credit balances and under payment work queues.
  
• Completes work within authorized time to assure compliance with departmental standards.
  
• Communicates effectively with payers and departmental staff to remove barriers to claim payment and to answer any questions relative to benefits of our billings as well as prior authorization issues.
  
• Submits and receives prior authorizations.
  
• Reacts to necessary changes by staying up-to-dates on payer requirements and systems capabilities.
  
• Performs other duties as assigned or needed to meet the needs of the department/organization.
  

Education:

• Preferred: Associates - Business

Work Experience:

• Preferred: A minimum of 1 year Related Experience

Physical Demands :

• Sit: Frequently (34-66%)
• Stand: Occasionally (5-33%)
• Walk: Occasionally (5-33%)
• Stoop/Bend: Occasionally (5-33%)
• Reach: Frequently (34-66%)
• Crawl: Not Applicable
• Squat/Crouch/Kneel: Occasionally (5-33%)
• Twist: Occasionally (5-33%)
• Handle/Finger/Feel: Continuously (67-100%)
• See: Continuously (67-100%)
• Hear: Continuously (67-100%)

Weight Demands:

• Lift -Floor to Waist Level: Sedentary (< 10 pounds)
• Carry: Sedentary (< 10 pounds)
• Push/Pull: Sedentary (< 10 pounds)
• Slide/Transfer: Not Applicable

Working Conditions:

• Indoor: Continuously (67-100%)
• Outdoor: Not Applicable
• Extreme Temperature: Not Applicable

Driving Requirement Definitions:

• Professional Drivers: Persons who drive as their main responsibility OR transport passengers or hazardous materials.
• Frequent Drivers: Persons whose main responsibility is not driving, but drive daily or almost daily.
• Occasional Drivers: Persons who drive from once per month to as frequently as once per week.
• Infrequent Drivers: Persons who are generally not expected to drive.

Driving Requirement for this position:
Infrequent Driver

Reference ID: R4977

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