
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.
🔥 7 minutes ago
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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.
• Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards. • Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers. • Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections. • Updates and confirms as necessary to allow processing of claims to insurance plans. • Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients. • Attaches referrals/authorizations to appointments/charges if available. • Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals. • Makes and receives calls to/from patients to collect on self-pay balances and any other outstanding balance. • Councils patients face to face when patients have questions or concerns regarding outstanding balances. • Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines. • Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement. • Identifies and communicates trends and/or potential issues to management team. • Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office. • Other duties as assigned by leadership.
• High school diploma/GED or equivalent working knowledge preferred. • Minimum two to three years of billing experience in a physician practice. • 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. • Prefer prior coding experience with CPC, CCS, RHIT or RHIA Certification. • Knowledge of government provisions and billing guidelines. • Advanced computer knowledge, including Window based programs.
• Normal office environment
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