Wakefield & Associates
  • 11-Nov-2021 to 10-Jan-2022 (EST)
  • Georgia - EBO
  • Atlanta, GA, USA
  • Full Time

General Summary of Duties

The Medicare Part A and B Insurance Representative is responsible for working with Medicare Part A and B to verify benefits to assist unit in resolving consumer account balances and working with consumers on behalf of our client as an extended business partner.

Job Requirements

  • Knowledge of the UB04 claims format
  • Working knowledge of DDE/eSolutions
  • Knowledge of the billing codes relating to CPT/HCPCS, ICD10
  • Knowledge of Medicare deductibles and coinsurance
  • Ability to pay attention to detail when reviewing charges for duplicates as well as billable vs non billable items
  • Ability to sort and file materials correctly by alphabetic or numeric systems
  • Good listening skills
  • Ability to maintain effective working relationships with patients, clients, employees, the public, and internal and external clients
  • Ability to maintain confidentiality of information and documents
  • Ability to read, understand and follow oral and written instruction
  • Must be a self-starter, self-managing, and self-motivated
  • Must be team and company oriented

Duties of Job

  • Review and identify inappropriate denials for immediate resolution
  • Knowledge of the appeals process relating to Medicaid/Medi-Cal accounts
  • Ability to identify incorrect payments (under-payment) from Government agencies
  • Maintain patient confidentiality when answer telephone inquiries from Insurance companies about account status, balances, and billed charges
  • Maintain familiarity with hospitals contractual agreements
  • Compliance with all billing policies as mandated by State and Federal Regulations
  • Ability to determine billable vs non-billable charges
  • Inform Director of any billing delays due to systems malfunction, coding, authorizations, etc


  • Major Medical Insurance
  • Flexible Spending Account
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Long Term & Short Term disability 100% paid by employer after 1 year
  • Voluntary Term Life
  • 401(k) Savings Plan
  • UNUM Supplemental Insurance
  • Paid Holidays
  • Paid Time Off
Wakefield & Associates
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