Insurance Follow-Up Rep / Medical Collector

Insurance Follow-up Representative / Medical Collector

Center for Bone & Joint Surgery is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise. We offer a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy.

As Center for Bone & Joint Surgery continues to grow, we are looking for an Insurance Follow-up Representative / Medical Collector.

Essential Functions

• Reviews insurance denials and rejections to determine next appropriate action steps and obtain 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 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 of reducing the accounts receivable of insurance balances by working through outstanding accounts.
• Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff.
• Identifies and communicates trends and/or potential issues to management team.
• Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.

Experience

• Minimum one to three years of experience in medical billing and collections.
• Must be able to communicate effectively with insurance carriers and patients and be capable of establishing good working relationships with both internal and external customers.

Knowledge

• Knowledge of the physician billing processes ICD-10 and CPT coding.
• Knowledge of computer systems. Experience with Athena billing & collections preferred.
• Advanced computer knowledge, including Window based programs.

Skills

• Skill in customer service and an understanding of The HOPCo code of conduct and culture.
• Skill in using computer programs and applications including Microsoft Excel, Microsoft Word and Outlook.
• Skill in establishing good working relationships with both internal and external customers.

Abilities

• Ability to multi task in a fast-paced environment. Must be detailed oriented with strong organizational skills.
• Ability to understand patient demographic information and determine insurance eligibility.
• Ability to work independently and demonstrate the ability to analyze data.

Environmental Working Conditions

Normal office environment.

Physical/Mental Demands

Requires sitting and standing associated with a normal office environment. Combination of bending, lifting and transferring activities. Manual dexterity using a calculator and computer keyboard.

Organizational Requirements

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:

• Competitive Health & Welfare Benefits after 30 days of service
• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan with company match after 30 days of service
• Employee Assistance Program that is available 24/7 to provide support
• Paid Time Off
• Paid Holidays
• and more...

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

HOPCo | Healthcare Outcomes Performance Company