Insurance Follow-Up Representative

Southeast Orthopedic Specialists, LLC; Jacksonville (FL); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Monthly stipend for ancillary benefits

HSA with company match

401k plan

Employee Assistance Program (EAP)

Paid Holidays & PTO

Employee Appreciation Days/Events

Job summary

Southeast Orthopedic Specialists, LLC is hiring Insurance Follow-Up Representatives for our Central Business Office in Jacksonville, FL. The role focuses on pursuing reimbursements from insurance payors and reducing patient accounts receivable through proactive follow-up and appeals.

The ideal candidate will have at least two years of medical claims processing experience, be proficient with EOBs/denials, and possess strong computer skills (Word/Excel).

Qualifications

• 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.

Responsibilities

• Review insurance denials to determine and take next 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 reimbursement.
• Assume full responsibility for reducing the accounts receivable of insurance balances by working through outstanding accounts.

Skills

Two years medical claims processing

Strong communication with payors

Attention to detail

Tools

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

This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.