Private Insurance Accounts Representative

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The Private Insurance Accounts Representative (PIAR) is responsible for timely collection of account balances from Medicare and private (non-contracted) insurance carriers and patients. The PIAR also processes returned checks and provides clerical and administrative support relating to Medicare and private insurance issues to insurance carriers, patients, clinics and administrative personnel. Based on business requirements, on occasion, PIAR will be expected to perform other duties within the billing office as assigned by Private Billing Section Supervisor (PBSS).

Work Hours:

The normal work-week is 35-40 hours/week full-time, Monday through Friday as scheduled. Occasional overtime or variations (including evenings and Saturdays) may be required or authorized.

Education & Training:

  • Must have High School diploma or GED
  • Must have one of the following:
    • 2 years of related experience
    • Certificate in related field plus 1 year related work experience

Position Advancement:

  1. Must possess good customer service skills
  2. Must be organized, detailed oriented and able to adapt quickly to stressful work environment
  3. Must be able to manage time to ensure completion of tasks, while paying attention to detail
  4. Must answer phones in a timely manner while being professional and courtesy
  5. Must be punctual and reliable in attendance

Essential Knowledge, Skills & Abilities:

  1. Must have basic knowledge of Medicare and Managed Care insurance
  2. Must have a working knowledge of Accounts Receivable (AR)

Essential Job Functions & Duties:

  1. Works Medicare and non-contracted managed care accounts
    1. Verifies eligibility and benefits
    2. Files or refiles claims
    3. Appeals claims
    4. Re-files corrected claim and/or adjusts as needed
  2. Works clearing house claims to ensure timely submission of claims
  3. Identifies recurring processing errors and work with the corresponding teams (internal or external) for resolution
  4. Process non-payment EOB’s as assigned
  5. Maintains and improves knowledge of Medicare rules and procedures through ongoing training and education
  6. Interact with staff members professionally

Customer Service Skills:

  1. Answers department phones
  2. Answers questions from internal and external customers in a professional manner
  3. Responds to request from internal and external customers in a professional and timely manner
  4. Meets the service expectations of patients
  5. Meets the service expectations of internal customers
  6. Meets the service expectations by external customers
  7. Resolves problems identified by patients
  8. Resolves problems identified by internal customers
  9. Resolves problems identified by external customers
  10. Follows through on commitments
  11. Interacts with co-workers in other departments in a manner that promotes teamwork and facilitates company goals

Working Conditions & Risks:

Work is indoors in a well lighted, and seasonally heated and cooled business office. Job hazards are estimated to be minimal (low risk). Potential risk exists from accidents while using routine office equipment.

Physical Requirements:

Position requires occasional need to lift heavy (30-50lbs) boxes from chest height to floor to chest height. Prolonged sitting, sorting, moving about, and intermittent typing approximately 4-6 hours per day routinely. Good vision, good hearing, and clear speech required (correctable). Repetitive motions consist of extended periods of upper body and upper limb movements (arms, hands, and wrists) prolonged use of phone and computer.

Before applying for this position you need to submit your online resume. Click the button below to continue.


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