Insurance Follow-Up Representative

Southeast Orthopedic Specialists • Jacksonville, FL

5d • Onsite

About The Position

Southeast Orthopedic Specialists is hiring Insurance Follow-Up Representatives for their Central Business Office in Jacksonville, FL. This role is responsible for following patient accounts through insurance payors to ensure proper reimbursement to the practice. The company was established in 2001 and is a regional leader in musculoskeletal medicine, aiming to make five-star orthopedic care accessible to many.

Requirements

• Minimum of two years of medical claims processing experience.
• Able to read and understand the Explanation of Benefits and denial reasons.
• Advanced computer knowledge, including Windows-based programs such as Word and Excel.
• Experience working with Blue Cross/Blue Shield, Commercial insurance companies, and Workman's Compensation carriers.

Responsibilities

• Review insurance denials to determine and take the next appropriate action steps to receive payment from the payor.
• Appeal claims that have been denied for no auth, medical necessity, etc.
• Verify receipt of claims with insurance plans to ensure timeliness of claims reimbursement.
• Assume full responsibility for reducing the accounts receivable of insurance balances by working through outstanding accounts.
• Communicating with payors through phone calls, emails, and payor portals.
• Process and take action on any written correspondence from insurance payors.
• Identify and trend reasons for claim denials.
• Resolve claim discrepancies reported by patients and other clinical departments.

Benefits

• Competitive Health & Supplemental Benefits
• Monthly stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan
• Employee Assistance Program available 24/7
• Employee Appreciation Days/Events
• Paid Holidays & Paid Time Off

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed