Insurance Coordinator

Orthopaedic & Spine Center of the Rockies•Greeley, CO

6d•Onsite

About The Position

OCR has been the premier provider of orthopaedic care in Colorado, Wyoming, and Nebraska for 55 years! As we continue to grow, we are looking for individuals who share our values and are looking to contribute to our mission and vision. Are you passionate about patient care, teamwork, and inspiring others? If so, join the specialists in the medicine of motion today! The Insurance Coordinator primarily manages all aspects of assigned insurance carriers, including data entry for practice/surgery charges, delivering receipts for patients with insurance, and researching rejected claims to determine an internal procedure for correcting, refiling and follow-up. This position is also responsible for communicating changes in insurances policies, maintaining up-to-date reference materials and ensuring compliance with all insurance rules and regulations. The Insurance Coordinator must have the ability to meet with patients regarding insurance benefits and eligibility as well as implementing external training programs for patients. They maintain accounts receivable aging and routinely audit claims while performing aggressive collection work where necessary.

Requirements

High school diploma or equivalent is required.
Minimum one year experience in the insurance or medical industry or equivalent experience with collections in a business/accounting department.
Knowledge of medical terminology preferred.
Core competencies in quality, detail oriented, communication, teamwork, and confidentiality.

Responsibilities

Follows up on denials, claim suspensions, and severe reductions in reimbursement promptly, exercise all options to obtain payment.
Maintains up-to-date reference materials on respective insurance rules and regulations and obtains a concise understanding of these regulations for assigned insurance carriers to ensure complete compliance with all insurance rules and regulations for assigned insurance carriers.
Communicates changes in respective insurance policies to supervisor for dissemination to other staff.
Responsible for maintaining positive accounts receivable for assigned insurance carriers. Demonstrates consistent and complete resolution collection work on primary and secondary claims.
Identifies accounts for outside collection on a timely basis and prepares appropriate paperwork for physician-decision and submission to a collection agency, if applicable.
Obtains a general understanding of insurance carriers assigned to other insurance coordinators and communicates changes and/or adjustments needed.
Meets with patients regarding insurance benefits and eligibility prior to surgery as well as outstanding patient balances.
Establishes payment arrangements for patients per guidelines established by the supervisor and follow department protocol for approving arrangements outside of established guidelines.
Prepares adjustments, as needed, to accounts for assigned insurance carriers and submits to the supervisor for approval, for processing weekly.
Accepts primary responsibility for answering the business phone outside line.
Communicates all concerns, risk management issues, breakdown in protocol and constructive criticisms to supervisor. Follows chain-of-command established by supervisor when addressing protocol issues outside of business office department.