Insurance Follow Up Representative

🕒 June 13

🌵 Arizona – Remote

🌵 Arizona – 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

🏥 Healthcare

🤝 B2B

☁️ SaaS

💰 Private equity on 2019-02

Healthcare • 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

• 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.

🎯 Requirements

• 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.