What are the responsibilities and job description for the Insurance Follow-Up Rep position at The Center for Orthopedic and Research E?
Job Description
Job Description
Healthcare Outcomes Performance Company the managing partner of Arizona-based entities, CORE Institute, Northern Arizona Orthopaedics, CORE Institute Specialty Hospital, Michigan-based CORE Institute, and Florida-based Southeast Orthopedic Specialists.
Healthcare Outcomes Performance Company (HOPCo) is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.
As HOPCo continues to grow, we are looking for an Insurance Follow-Up Representative in our Corporate Headquarters. Please see below for the functions and requirements for this position.
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 CORE Institute policies and procedures, including those specific to billing and the Revenue Cycle.
EDUCATION
EXPERIENCE
KNOWLEDGE
SKILLS
ABILITIES
ENVIRONMENTAL WORKING CONDITIONS
PHYSICAL / MENTAL DEMANDS
ORGANIZATIONAL REQUIREMENTS
