Insurance Follow-Up Representative

3 weeks ago

Newtown Square, United States Center for Orthopedic and Research Excel Full time
Job DescriptionJob Description

Premier Orthopaedics and Sports Medicine is looking for an Insurance Follow-Up Representative to work at our Newtown Square, PA corporate office.

The Company: Premier Orthopaedics is a full-service orthopaedic practice formed in 2000 that specializes in the diagnosis and care for a wide range of orthopaedic injuries and conditions. Through partnership with the Healthcare Outcomes Performance Company (HOPCo), we have grown to over 50 specialty locations and over 100 physicians across the Greater Philadelphia region

We’re proud of the company we’ve built as we’ve grown to over 1000 employees to make Premier a place that people love to come to work every day

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, Pharmacy, Vision, and Dental Plan Benefits
  • Disability and Protective Benefits
  • HSA with qualifying HDHP plans with company match
  • 401k plan with company match
  • Employee Assistance Program that is available 24/7 to provide support
  • Benefits eligibility on the 1st of the month after hire date

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.

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