Insurance Follow Up Representative
About The Position
The Center for Orthopedic Research and Education (CORE Institute) is seeking an Insurance Follow Up Representative. CORE Institute has been recognized by Ranking Arizona as #1 for Orthopedic Practices, #1 for Healthiest Healthcare Employers, and #3 for Best Healthcare Workplace Culture, and is a winner in Best Places to Work. This role involves reviewing insurance denials and rejections, verifying patient information and insurance eligibility, researching billing information, and ensuring claims are processed for maximum reimbursement. The representative will also be responsible for reducing accounts receivable by working outstanding accounts and identifying trends for management.
Requirements
- Minimum two to three years of experience in medical billing.
- 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 computer systems.
- Experience with GE patient management system.
- Knowledge of the physician billing processes, ICD-10, and CPT coding.
Nice To Haves
- HSD/GED
Responsibilities
- Reviews insurance denials and rejections to determine the next appropriate action steps and obtain the 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 maximum reimbursement.
- Researches all information needed to complete the 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 for reducing the accounts receivable of insurance balances by working through outstanding accounts.
- Analyzes account for proper claims processing and payment posting through inquiries from patients or staff.
- Identifies and communicates trends and/or potential issues to the management team.
- Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
