Insurance Representative Job Description
Insurance Representative Duties & Responsibilities
To write an effective insurance representative job description, begin by listing detailed duties, responsibilities and expectations. We have included insurance representative job description templates that you can modify and use.
Sample responsibilities for this position include:
Insurance Representative Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Insurance Representative
List any licenses or certifications required by the position: CSS, ACC, I-CAR
Education for Insurance Representative
Typically a job would require a certain level of education.
Employers hiring for the insurance representative job most commonly would prefer for their future employee to have a relevant degree such as High School and Collage Degree in General Education, Education, Associates, Business, Management, Business/Administration, Communications, Technical, Finance, Accounting
Skills for Insurance Representative
Desired skills for insurance representative include:
Desired experience for insurance representative includes:
Insurance Representative Examples
Insurance Representative Job Description
- Re-submit claims to government agencies, medical service bureaus and insurance companies ensuring that accounts are billed appropriately
- Service all insurance accounts in order to maintain business
- Assisting supervisory and non-supervisory employees with various administrative support tasks
- The work performed by these employees is predominately general administrative in nature, as opposed to specific administrative tasks that are directly related to a specialty functions , marketing, engineering, human resources
- Applies developed knowledge of the job skills, company policies and procedures to complete a wide variety of difficult assignments/tasks
- Works on assignments that are moderately complex in nature and require ordinary problem resolution and independent judgment
- Works under limited supervision and normally receives no instructions on routine work and general instructions given for new assignments
- Following up with insurance carriers for information
- Maintaining the book of business by calling on pending cancellations, renewals
- Provide clerical and member service support to the field sales team
- Successful completion of a full 4-year course of study in an accredited college or university leading to a bachelor's or higher degree in related/relevant field, , health administration, college student personnel
- Commitment to a scheduled environment
- Currently recruiting for Full Time shifts
- Minimum 1 year of Call Center/Customer service experience
- Position may include Saturday as a regular work day, with ONE day off during the week (either Tue, Wed, Thu)
- Healthcare operating system experience including data entry, record look-up and viewing
Insurance Representative Job Description
- Responsible for resolving customer incidents on the telephone using various software tools
- Will escalate certain incidents to higher levels appropriately using various software tools
- Ready to work fulltime in an inbound call center environment
- Will perform other duties/tasks as assigned
- This is a limited term employee position
- Answer provider calls and assist them with billing questions using reference manuals, reports, and online
- Interview patients and completes all paperwork necessary to ensure the admitting process is efficient and all clinic and regulatory policies are in compliance
- Notifies patient of his/her financial responsibility for services to be provided
- Accurately and timely post private payments, insurance payments, disallows and/or denials to appropriate patient account, calculate patient responsibility, interpret explanation of benefit message codes
- Re-submit claims to government agencies, medical service bureaus, and insurance companies ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data, and patient information submitted
- Ability to make decisions quickly by balancing company guidelines and customer needs
- Basic PC knowledge and expertise
- Demonstrated ability to multi-task and meet assigned deadlines
- Ability to provide effective feedback
- Exception Processing experience, Attention to detail, Good communication skills
- Minimum Six (6) months customer service/insurance servicing experience or equivalent education/training required
Insurance Representative Job Description
- Completes complex tasks and defined processes
- Coordination of benefits with other insurance for claims adjudication
- Manage inbox – Incoming tickets, preliminary and post QC review, assignment
- Queue Management in compliance with Service Level Agreements
- Work with technical and business teams
- Manage System Notifications - Information, critical, or an outage
- Knowledge Management – Information looping back from ticket resolutions into the knowledge base
- Call Center role (will be on the phone for this role)
- Modify policies at loan level by following established guidelines and utilizing internal tracking system to update information as required and contribute to routine documentation processing workflows
- Resolve information gaps by contacting carriers and agencies as required to gather policy information and other missing data and update systems and records as appropriate
- Previous collections, call center experience preferred
- Must be an effective communicator with strong Interpersonal skills necessary to promote a cooperative team environment, provide good customer service and negotiate with insurance companies as needed
- Ability to perform basic arithmetic calculations in order to perform duties described above
- Experience following established procedures to complete processing tasks
- Basic knowledge of data entry processes and procedures
- Analyze data on a problem-to-problem solution
Insurance Representative Job Description
- Complete high volume of data entry by quickly and accurately processing loan-related task queues to meet productivity and quality requirements
- Manage individual performance by setting work-related goals, tracking personal achievements and communicating with management to report on success and identify improvement strategies
- Build insurance servicing skills and knowledge by soliciting performance feedback, participating in cross-training and learning additional processes and procedures to support multiple workflows and contribute to effectiveness of team operations
- Support QBE values in personal work behaviors, decision-making, contributions and interpersonal interactions
- Part time position working 20 hours per week
- Handle calls from members and employers
- Will assist the prior authorization department with multiple programs
- Some work may include interaction with the client
- Will handle multiple task as needed to help the department move forward
- Complies with contract requirements, business unit rules and related industry and legal regulation
- Previous experience in insurance customer service with personal auto, commercial, motorcycle, recreational vehicle, accident and health, supplemental health, and/or homeowners products
- Minimum of two years experience processing enrollment applications, or performing medical billing/administrative tasks
- Ability to work with details and follow directions
- Ability to use multiple window based screens to perform work
- At least three years of insurance verification experience preferred
- A current Claims Adjuster Licenses is a plus
Insurance Representative Job Description
- Resolve third party denials through appropriate research of carrier specific billing guidelines and through validation of correct billing information being submitted
- Appeal claims that have either been denied or paid incorrectly either via phone, on-line or in writing dependent on the unique requirements of the payer
- Respond to communication from third-party payers with requests for information or follow-up
- Collect and review medical documentation on unpaid claims to ensure compliance with Federal and State billing guidelines
- Re-submit claims to third party payers ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data, and patient information submitted
- Conducts detailed research and provides a clear description of findings
- Uses professional writing abilities for client communication and State publications
- Completes work assignments beyond a general support level
- Manages tasks and assignments without detailed direction
- Identifies, prioritizes and resolves issues independently, and escalates more complex questions or issues as appropriate
- Experience working in a sales environment preferred
- A successful candidate will have excellent communication and interpersonal skills, superior organizational skills and a commitment to maintaining superior customer relationships
- This job requires excellent attendance track record
- Computer proficiency in Windows-Based Applications
- Excellent fluency in the language to be supported
- Experience in a phone based role is preferred