Insurance Follow-Up Rep / 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.

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

• Customer service and an understanding of The HOPCo code of conduct and culture.
• Using computer programs and applications including Microsoft Excel, Microsoft Word and Outlook.
• Establishing good working relationships with both internal and external customers.

ABILITIES

• Multi tasking in a fast-paced environment.
• Detail oriented with strong organizational skills.
• Understanding of patient demographic information and determining insurance eligibility.
• Demonstrating the ability to analyze data.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.

PHYSICAL/MENTAL DEMANDS

• 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.

Benefits

• 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...