Health Insurance Operations Manager manages and maintains daily health insurance operations in multiple service areas, including account installation, implementation, client support, contract administration, claim processing, and enrollment and eligibility. Handles and settles complicated customer service issues which can not be resolved by lower level staff. Being a Health Insurance Operations Manager monitors performance of each service area. Requires a bachelor's degree or its equivalent. Additionally, Health Insurance Operations Manager typically reports to senior management or Director. The Health Insurance Operations Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Health Insurance Operations Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
General Job Description: •Performs a variety of complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of third party billing records, and resolution of a variety of problems. •Follows up on submitted claims and patient billing; resubmits claims or resolves problems. May handle cash items and accounts receivable posting. Essential Job Functions: •Processes billings to patients and third party reimbursement claims; maintains supporting documentation files and current patient addresses. •Processes patient statements, keys data, posts transactions, and verifies accuracy of input to reports generated. •Researches and responds by telephone and in writing to patient inquiries regarding billing issues and problems. •Follows up on submitted claims; monitors unpaid claims, initiates tracers; resubmits claims as necessary. •May receive and receipt cash items and third party reimbursements; posts and reconciles payments to patient ledgers. •Balances daily batches and reports; prepares income reports and statistics; distributes reports. Education and Experience Required: •HSD or GED •Two years to four years of direct billing experience
Job Type: Full-time
Pay: $28,425.00 - $117,841.00 per year
Benefits:
Schedule:
Work Location: Multiple locations
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