Insurance Follow Up Representative

🕒 Junho 13

🌵 Arizona – Remoto

🌵 Arizona – Remote

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

🔒 Seguros

🚫👨‍🎓 Sem graduação necessária

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Healthcare Outcomes Performance Co. (HOPCo)

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🏥 Saúde

🤝 B2B

☁️ SaaS

💰 Private equity em 2019-02

Healthcare • B2B • SaaS

A Healthcare Outcomes Performance Co. (HOPCo) é a maior organização de cuidados ortopédicos baseados em valor nos EUA, especializada na entrega, gestão e criação de valor em cuidados abrangentes do sistema musculoesquelético (MSK). Liderada por médicos e executivos ortopédicos, a HOPCo opera uma rede clínica integrada de MSK acreditada e oferece soluções de parceria prática e de sistema de saúde, programas de saúde populacional voltados para o pagador e cuidados baseados em valor, análises e relatórios de resultados, e ferramentas digitais de engajamento do paciente para alinhar partes interessadas, melhorar resultados e reduzir os custos totais de MSK.

Descrição

• 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. • Determines 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.

🎯 Requisitos

• Minimum two to three years of experience in medical billing. • Must be able to communicate effectively with physicians, patients, and the public. • Capable of establishing good working relationships with both internal and external customers. • Preferred Knowledge of computer systems. • Experience with GE patient management system. • Knowledge of the physician billing processes, ICD-10, and CPT coding.