Job Description
Job Description
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 offers 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 a Collections Specialist ( Insurance Follow-up Representative) with experience in Orthopedics, Wound Care, and Athena.
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 confirmsas 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 claimsmaximum reimbursement.
Researches all information needed to complete billing process including obtaining information from providers, ancillaryservices 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 outstandingaccounts.
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 physicians, patients and the public and be capable of establishing goodworking relationships with both internal and external customers.'
Athena experienceOrthopedic experienceWound Care experienceKNOWLEDGE
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
Hybrid (remote and 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 serviceMonthly $43 stipend to use toward ancillary benefitsHSA with qualifying HDHP plans with company match401k plan with company match after 30 days of serviceEmployee Assistance Program that is available 24 / 7 to provide supportPaid Time OffPaid Holidaysand more...
Salary : $43
