Medical Office Insurance Representative

Job Description

Job Description

About Us:
We are a growing, busy and patient-focused medical office dedicated to providing top-quality healthcare in a supportive and compassionate environment. We are seeking an experienced and detail-oriented Insurance Representative to join our administrative team and help ensure efficient and accurate insurance processing.

Job Summary:
The Medical Office Insurance Representative plays a crucial role in our billing office operations. This individual is responsible for verifying insurance coverage, obtaining prior authorizations, assisting with claim submissions, contacting insurance companies regarding unpaid claims, filing appeals, A/R follow up, patient collections and serving as a liaison between patients, providers, and insurance companies.

Key Responsibilities:

• Verify accurate insurance information has been inputted into the practice management system on all patients

• Review insurance claims for accuracy and submit to insurance carriers in a timely manner

• Appeal claims that are processed incorrectly for resolution in a timely manner

• Contact insurance companies regarding claims that need to be adjudicated timely

• Follow up on unpaid or denied claims and work toward resolution

• Communicate with patients regarding their insurance coverage, co-pays, and billing questions

• Collaborate with clinical and administrative staff to ensure smooth patient flow and accurate documentation

• Stay current on insurance policies, coding changes, and regulatory updates

Qualifications:

• High school diploma or equivalent required; associate degree or certification in medical billing/insurance preferred

• Minimum of 2 years' experience in a medical office insurance or billing role

• Strong understanding of medical insurance plans, coding, and billing processes (ICD-10, CPT, HCPCS)

• Familiarity with electronic medical records (EMR) and billing software (e.g., NextGen, Epic, etc.)

• Excellent attention to detail, problem-solving skills, and organizational abilities

• Strong interpersonal and communication skills

• Ability to work independently and as part of a team in a fast-paced environment