Revecore Technologies
Purpose
Investigates and coordinates no-fault benefits for accident claims from auto, home or other liability insurance policies. Resolves accounts as quickly and accurately as possible, obtaining maximum reimbursement.
Essential Duties and Responsibilities
- Reviews and researches accident claims to investigate possible leads.
- Coordinates insurance benefits for patients. Contacts patients, insurance representatives, and attorneys to verify relevant details and obtain maximum payments. Bills no-fault and TPL carriers when appropriate.
- Requests documentation from insurance representatives when no no-fault insurance exists.
- Closes and returns claims to client upon resolution using correct text and procedures in regards to denial process.
- Maintains proper account documentation in AcciClaim.
- Responds to email and phone correspondence per department guidelines.
- Resolves any issues noted in the QA work reviews.
- Continues education and professional development by attending staff training, department Lunch and Learns, Revecore University, and attending Continuing Education Classes.
- Assists Team Leader with new employee training. Provides initial one-on-one training in position basics and best practices, and serves as a resource for new employees.
- Completes special reports as required, such as aged reports, checklist audits, denial reports, etc.
- Performs special projects as assigned.
- Maintain confidential information, whether verbal, written or electronic, which I will learn in the course of my work at Revecore.
- Will not access or attempt to access confidential data that is unrelated to my job duties in the course of my work at Revecore.
- Will not disclose Protected Health Information (PHI) in violation of law.
Job Knowledge, Skills and Abilities Required
- Ability to communicate effectively verbally and in writing. Proven ability to speak on a one-to-one basis with patients, attorneys and adjusters using appropriate vocabulary and grammar to explain what is required and obtain information.
- Demonstrated ability to work independently and follow-through on assignments with minimal direction.
- Must be able to pay attention to detail in order to produce accurate work, often under minimal supervision.
- Proven ability to be assertive in order to proactively resolve issues.
- Must be skilled in problem analysis and resolution.
- Demonstrated ability to organize and set priorities according to situational demands.
- Working knowledge of computer functions including the internet, and computer software such as Microsoft Office suite and Word Perfect; working knowledge of or ability to learn AcciClaim and SharePoint.
Education and Experience Requirements
- High school diploma or equivalent required.
- At least one year of experience in a professional office environment required; experience inhealth and/or auto insurance preferred.
- Experience with Coordination of Benefits and Subrogation requirements is a plus.
Supervisory Responsibilities None.