Insurance Follow-Up Rep

Healthcare Outcomes Performance Co. (HOPCo)•Wellington, FL

2d•Onsite

About The Position

Center for Bone & Joint Surgery is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise. We offer a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy. As Center for Bone & Joint Surgery continues to grow, we are looking for a Insurance Follow-up Representative.

Requirements

Minimum one to three years of experience in medical billing and collections.
Must be able to communicate effectively with physicians, patients and the public and be capable of establishing good working relationships with both internal and external customers.
Knowledge of the physician billing processes, ICD-10 and CPT coding.
Knowledge of computer systems. Experience with Athena billing & collections preferred.
Advanced computer knowledge, including Window based programs.
Skill in customer service and an understanding of The HOPCo code of conduct and culture.
Skill in using computer programs and applications including Microsoft Excel, Microsoft Word and Outlook.
Skill in establishing good working relationships with both internal and external customers.
Ability to multi task in a fast-paced environment.
Must be detailed oriented with strong organizational skills.
Ability to understand patient demographic information and determine insurance eligibility.
Ability to work independently and demonstrate the ability to analyze data.

Nice To Haves

Experience with Athena billing & collections preferred.

Responsibilities

Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Verifies receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims for maximum reimbursement.
Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
Obtains and attaches referrals/authorizations to appointments/charges.
Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards.
Assumes full responsibility of reducing the accounts receivable of insurance balances by working through outstanding accounts.
Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff.
Identifies and communicates trends and/or potential issues to management team.
Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.