Check over insurance claims forms as they are submitted and review each section for accuracy and completeness
Confirm that the patient and the treatment or prescription are covered parts of the insurance plan by researching the plan details using a computerized database or calling the physician's office
Submit each insurance claim after verification for final processing via an electronic submittal form system and review the reception of the claim with a final check
Interpret the language in the overview of benefits summary explanation for the insurance policy and apply interpretation to the claims review process
Update policy forms and claims information when insurance coverage changes have occurred and notify appropriate parties of the changes when necessary
Maintain knowledge of all appropriate medical insurance coverage laws in the local, state, and federal jurisdiction area when reviewing claims submissions
Follow all required medical privacy laws when discussing private information about patients with physicians, healthcare managers, or other staff members in the insurance agency
