Insurance Follow Up Representative

Healthcare Outcomes Performance Company • Phoenix, AZ

10h • Onsite

About The Position

The Center for Orthopedic Research and Education (CORE Institute) is seeking an Insurance Follow Up Representative. This role is responsible for reviewing insurance denials and rejections, verifying patient information and insurance eligibility, and ensuring claims are processed for maximum reimbursement. The representative will research necessary information for billing, obtain and attach referrals/authorizations, and maintain productivity and accuracy metrics. This position assumes responsibility for reducing accounts receivable by working outstanding accounts, analyzing accounts for proper claims processing, and identifying/communicating trends to management. The role requires adherence to all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle. The 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.

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