BLUE CROSS BLUE SHIELD INSURANCE CLERK

Job Title

Clinic Hours:

M-F 8am to 5pm

Summary:

Taking care of all accounts with Blue Cross Blue Shield as their primary insurance.

Duties:

1. File all Texas and Arkansas Blue Cross Plans Claims. This involves making sure all correct information is printed on the claims before mailing them.
2. Works all above insurance denials. Must decide why a claim was denied, correct it if possible and re-file as soon as possible.
3. If a procedure is denied that we cannot collect on, maybe the procedure is bundled or global, then you must write up a request for a write off to forward to Data Department.
4. Answer phone calls from the patients or other departments.
5. File all supplement insurance claims, which involves matching the claims with the Blue Cross EOB’s and mailing them.
6. Order claims form EOB’s that don’t have a matched claim and vice versa.

Qualifications:

1. High school graduate or equivalent.
2. Computer experience.
3. Must know how to use a CPT book and ICD-10 book. At least 2 – 4 weeks of training is required.
4. At least one year follow-up experience on claims is desirable.

QUALIFICATIONS

1. Pleasant, friendly disposition with the ability to work with patients as well as employees.
2. Awareness of need for discretion and for keeping confidential all matters relating to clinic, the employees and the patients.
3. Intelligence to use judgement and initiative in determining the course of action with filing claims.
4. Ability to handle stressful situations while remaining calm.
5. Exhibits a cooperative helpful manner toward co-workers.
6. Tact and diplomacy when dealing with patients.