Medical Insurance Representative II

  • location: Houston, TX
  • type: Temp to Perm
  • salary: $19 per hour

job description

Medical Insurance Representative II

Ensures the efficient operation and effective reimbursement of third party account receivables by researching accounts, refiling or appealing claims, submitting additional medical documentation, and tracking account status by monitoring unresolved third party accounts. Initiates contacts and negotiates appropriate resolution (internal and external) as well as receives and resolves inquiries and correspondence from third parties and patients. At least one year experience in claims resolution/claim follow-up with medical insurance/collections (including CMS-1500 and UB-04 forms) is required OR active Medical Insurance and Billing certification.  Working hours: Monday-Friday around 8 AM-5 PM  

Responsibilities

  • Initiates contact with guarantors/third party payors to collect on outstanding receivables
  • Review and work denial referrals for early identification of root cause of denial
  • Perform preliminary determination on whether denial can be overturned
  • Resolve denials in timely manner
  • Ensures that all Third Party Payor claim filing deadline appeals are submitted timely
  • Monitors accounts for updates on claim status and review of payment
  • Requests and initiates the billing or re-bill of claims
  • Posts all pre-determined adjustments within the hospital system


Skills
  • Telephone Etiquette
  • Insurance
  • Health Insurance Policies
Education
  • High School (required)
Qualifications
  • Years of experience: 1 year
  • Experience level:Experienced
Shift: First

Working hours: 8 AM - 5 PM

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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