Insurance Follow-Up Representative

🕒 June 19

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔒 Insurance

🚫👨‍🎓 No degree required

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Healthcare Outcomes Performance Co. (HOPCo)

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🤝 B2B

☁️ SaaS

💰 Private equity on 2019-02

B2B • SaaS

Healthcare Outcomes Performance Co. (HOPCo) is the largest orthopedic value-based care organization in the U. S. , specializing in comprehensive musculoskeletal (MSK) care delivery, management, and value creation. Led by orthopedic physicians and executives, HOPCo operates an accredited MSK clinically integrated network and offers practice partnership and health system solutions, payor-facing population health and value-based care programs, analytics and outcomes reporting, and digital patient engagement tools to align stakeholders, improve outcomes, and lower total MSK costs.

📋 Description

• 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.

🎯 Requirements

• Must have a minimum of two years of medical claims processing experience. • Must be 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.

🏖️ 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 • AND MORE!