Insurance Follow-Up Representative

The CORE Institute; Jacksonville (FL); On-site; USD 38,000 - 50,000; Full time

Benefits offered by this job

Monthly stipend for ancillary benefits

HSA with company match

401k plan

Employee Assistance Program

Paid Holidays & Paid Time Off

Job summary

The CORE Institute is seeking an Insurance Follow-Up Representative to join their Central Business Office in Jacksonville, FL. The role focuses on managing patient accounts through insurance payors to ensure proper reimbursement.

Ideal candidates will have at least two years of experience in medical claims processing and a strong ability to work with different insurance carriers. This position offers a robust benefits package, including a monthly stipend, HSA match, and 401k plans.

Qualifications

• Minimum of two years of medical claims processing experience.
• Ability to read and understand Explanation of Benefits and denial reasons.
• Experience with Blue Cross/Blue Shield and other insurance companies.

Responsibilities

• Review insurance denials and take appropriate action.
• Appeal denied claims for various reasons.
• Verify claims receipt with insurance plans.
• Reduce accounts receivable by working on outstanding accounts.
• Communicate with payors via phone, email, and portals.
• Process correspondence from insurance payors.
• Identify reasons for claim denials.
• Resolve claim discrepancies.

Skills

Medical claims processing experience

Understanding of Explanation of Benefits

Advanced computer knowledge

Experience with Blue Cross/Blue Shield

Tools

Windows-based programs (Word, Excel)

Job description

Established in 2001, Southeast Orthopedic Specialists is a regional leader in musculoskeletal medicine. We are dedicated to growing with our patients. Our reach will continue to expand to meet the needs of all patients, present and future. It is our wish to make industry-leading five-star orthopedic care accessible to as many people as possible.

As Southeast Orthopedic Specialists continues to grow, we are hiring Insurance Follow-Up Representatives for our Central Business Office located in Jacksonville, FL !Please see below for the functions and requirements for this position:

Insurance Follow Representatives are responsible for following patient accounts, through the insurance payors to ensure proper reimbursement to the practice.

In this role Insurance Follow Up Reps will:

• Review insurance denials to determine and take the next appropriate action steps to receive payment from the payor.
• Appeal claims that have been denied for no auth, medical necessity, etc.
• Verify receipt of claims with insurance plans to ensure timeliness of claims reimbursement.
• Assume full responsibility for reducing the accounts receivable of insurance balances by working through outstanding accounts.
• Communicating with payors through phone calls, emails, and payor portals.
• Process and take action on any written correspondence from insurance payors.
• Identify and trend reasons for claim denials.
• Resolve claim discrepancies reported by patients and other clinical departments.

The ideal candidate will have:

• Must have a minimum of two years of medical claims processing experience.
• Must be able to read and understand the Explanation of Benefits and denial reasons.
• Advanced computer knowledge, including Windows-based programs such as Word and Excel.
• Experience working with Blue Cross/Blue Shield, Commercial insurance companies, and Workman's Compensation carriers.

AtSoutheast Orthopedic Specialists, we are dedicated to taking care of you so you can take care of business! Our robust BENEFITS PACKAGE includes the following:

• Monthly stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan
• Employee Assistance Program available 24/7
• Employee Appreciation Days/Events
• Paid Holidays & Paid Time Off
• AND MORE!

Equal Opportunity Employer
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