Insurance Follow Up Representative

Healthcare Outcomes Performance Co. (HOPCo) • Phoenix, AZ

1d

About The Position

The Center for Orthopedic Research and Education (CORE Institute) is a highly-regarded organization, recognized by Ranking Arizona for its excellence in orthopedic practices, healthcare employer health, workplace culture, and being a Best Place to Work. This role is crucial for managing insurance denials and rejections to ensure timely reimbursement and efficient claims processing.

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.
• HSD/GED

Nice To Haves

• Knowledge of computer systems.
• Experience with GE patient management system.
• Knowledge of the physician billing processes, ICD-10, and CPT coding.

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.

Benefits

• Competitive Health & Welfare Benefits
• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan after 6 months of service with company match (Part-time employees included)
• Employee Assistance Program that is available 24/7 to provide support
• Employee Appreciation Days
• Employee Wellness Events

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED