Patient Account Representative

Position Title: Insurance Eligibility Specialist

Job Status: Full-Time

Work Schedule: Monday – Friday 8:30 - 5

FLSA Status: Non-Exempt

Benefits: Medical, Dental, Vision, 401K (Employer Contribution), Paid Time Off, Paid Holidays

Compensation: Starting at $19/HR (Based on experience)

About Us:

Atlantic Orthopaedics and Sports Medicine, established in 1987, is a leading private, physician-owned healthcare organization specializing in orthopedic care and sports medicine. With a strong commitment to patient care and a track record of excellence, we are expanding our team and seeking an Insurance Eligibility Specialist. This is a unique opportunity to join a team with extremely low turnover and high job satisfaction.

Our main practice is located in Portsmouth, NH with additional offices in York, ME and Dover, NH (Opening in Winter of 2025).

Position Summary

We are seeking a dedicated professional to join our esteemed and expanding orthopedic specialty group in the New Hampshire Seacoast area for a long-term employment opportunity. In this role, you will work under the guidance of the Billing Manager to manage all insurance eligibility functions and perform related tasks that support these responsibilities.

Working Relations

Positions reports to: Billing Manager

Internal Relationships: Office Staff, Clinicians

External relationships: Patients, Insurance Company Representatives

Position Requirements

Licenses or Certificates: Billing/coding certificate or special training a plus.

Education, vocational training, and experience:

• High School diploma or equivalent – associate or bachelor's degree in a business-related field preferred
• Minimum 2 years of experience in an insurance eligibility role.
• Intermediate to advanced computer and data entry skills
• Previous experience with insurance eligibility and/or billing experience
• Basic coding knowledge including CPT and ICD-10 and Orthopedic specialty experience is a plus

Skills and Abilities

• Maintain a professional attitude and appearance with excellent telephone communication skills.
• Proficient in Microsoft Word and Excel at an intermediate level.
• Strong mathematical abilities, including working with fractions, decimals, and understanding data relationships to formulate and implement strategies.
• College-level writing proficiency.
• Exceptional critical thinking skills to support efficient and effective insurance eligibility management.
• Highly organized with the ability to prioritize and multitask effectively.
• Prior experience with ModMed is advantageous.
• Must be highly motivated to meet performance goals set by management.

Job Responsibilities

The Insurance Eligibility Specialist’s tasks include, but are not limited to, the following:

• Verify patient insurance coverage and eligibility for orthopedic services.
• Communicate with insurance companies to resolve coverage issues or discrepancies.
• Accurately enter and update insurance information in the practice’s electronic health records (EHR) system.
• Assist patients with understanding their insurance benefits, coverage limits, and out-of-pocket costs.
• Review insurance policies to ensure compliance with state and federal regulations.
• Maintain detailed records of insurance verification and authorization processes.
• Assist patients in resolving any issues related to insurance coverage for services.
• Stay updated on changes to insurance policies and requirements, communicating updates to the team as needed.
• Ensure referrals and authorizations are obtained before appointments and comply with insurance policies.

Job Type: Full-time

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Application Question(s):

• Does the proposed hourly range of $19 - $21/hr meet your expectations?

Experience:

• insurance eligibility: 2 years (Preferred)

Ability to Commute:

• Portsmouth, NH 03801 (Required)

Ability to Relocate:

• Portsmouth, NH 03801: Relocate before starting work (Required)

Work Location: In person

Salary : $19 - $21