Summary: responsible for managing the new claims workflow, logging, and maintaining accurate data in the claims management system, responding to customer enquiries, and providing claim updates and processing timely invoice and sundry payments ensuring a proactive and seamless customer service. process insurance claims, new and existing, manage policy renewals, receiving and documenting SUD consumer's information, and documenting any new or existing changes to consumer's insurance policies.
Reports to: Clinical Manager as it relates to the daily task in the summary. Workers Supervised: NONE Interrelationship: Must be able to communicate all pertinent information to CEO, Operations, Human Resources, Officers, Quality Assurance, and Clinical Program Specialist. Primary Job Responsibilities: · Process insurance claims, including verifying accuracy of information, ensuring all necessary documentation is received, and liaising with insurance adjusters. · Manage policy renewals, including reviewing current policies, negotiating terms with insurers, and communicating changes or updates to policyholders. · Handle customer inquiries related to policies, coverage, and claims, providing detailed information, and resolving issues in a timely manner. · Coordinate with healthcare providers and other third parties to confirm coverage, authorize services, and facilitate direct billing arrangements. · Maintain accurate and up-to-date records of all insurance policies, claims, and correspondence in the company’s database. · Prepare and present detailed reports on claims statistics, policy renewals, and insurance costs to management for review and decision-making. · Develop and implement efficient administrative procedures to streamline insurance operations and improve customer service. · Conduct audits of insurance policies and claims to ensure compliance with regulatory standards and identify opportunities for cost savings. Phlebotomy.*Please note, administrative staff may be required to perform other administrative task outside of his/her primary job responsibilities related to administrative task at Life Care Inc.
Required Knowledge, Skills and Abilities
Demonstrates the ability to use standard office equipment such as telephones, computers, copiers, fax machines and others.
Displays the ability to communicate with others effectively, listen closely and convey points clearly.
Shows proficiency with computer programs which may include Microsoft Word, Excel, PowerPoint, Outlook and others.
Demonstrates excellent customer service skills and the ability to calm patients or clients who may be distraught.
- Shows the ability to calm frustrated clients quickly and make decisions based upon anticipated outcomes.
Possesses the ability to adjust to constantly changing workloads.
Education and Experience
This position requires only a high school diploma or GED.
Must have at least one to two years’ experience working within the chosen industry.
Certifed Phlebotomist
Work Environment
An Insurance Administrator works in a climate-controlled facility. This position requires office availability for at least 40 hours (about 1 and a half days) per week, Monday-Friday 9-5pm.
Job Types: Full-time, Part-time
Benefits:
- Flexible schedule
- Health insurance
- Paid time off
Weekly day range:
Work setting:
License/Certification:
- Insurance Producer License (Preferred)
- Life Insurance License (Preferred)
Ability to Commute:
- Washington, DC 20020 (Required)
Ability to Relocate:
- Washington, DC 20020: Relocate before starting work (Required)
Work Location: In person