What are the responsibilities and job description for the Insurance Follow-Up Representative position at HOPCo?
Premier Orthopaedics & Sports Medicine is looking for an Insurance Follow-Up Representative to work at our Newtown Square, PA corporate office.
At Premier Orthopaedics, 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
- Monthly $43 stipend to use toward ancillary benefits
- HSA with qualifying HDHP plans with company match
- 401k plan after 6 months of service with company match (Part-time employees included)
- Employee Assistance Program that is available 24/7 to provide support
- Employee Appreciation Days
- Employee Wellness Events
ESSENTIAL FUNCTIONS
- Reviews insurance denials and rejections to determine next appropriate action steps and obtains 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 all practice/site-specific protocols pertaining to this job description.
- Other duties as assigned.
EDUCATION
- High school diploma/GED or equivalent working knowledge preferred.
EXPERIENCE
- A minimum of two to three years of experience in medical billing.
REQUIREMENTS
- Must be able to communicate effectively with physicians, staff members, patients, and the public and be capable of
establishing good working relationships with both internal and external stakeholders.
KNOWLEDGE
- Knowledge of the physician billing processes, ICD-10 and CPT coding.
- Advanced computer knowledge, including Window based programs.
- Experience with GE patient management system
preferred. - Knowledge of insurance plan websites and portals.
- Knowledge of revenue cycle processes.
- Knowledge of policies and procedures with regards to physician billing processes including determining insurance eligibility and coordination of benefits.
SKILLS
- Skill in providing excellent customer service.
- Skill in using computer programs and applications.
- Skill in establishing good working relationships with both internal and external stakeholders.
- Skill in effective data collection and analysis.
ABILITIES
- Ability to maintain patient confidentiality.
- Ability to multitask in a fast-paced environment and work well under pressure.
- Ability to be detailed oriented with strong organizational skills.
- Ability to understand patient demographic information and determine insurance eligibility.
- Ability to work independently and as part of a team.
- Ability to communicate clearly and effectively.
Salary : $43
