Insurance Follow-Up Representative

Healthcare Outcomes Performance Co. (HOPCo); Jacksonville (FL); On-site; USD 40,000 - 50,000; Full time

Benefits offered by this job

Competitive Health & Supplemental Benefits

Monthly stipend for ancillary benefits

401k plan

Employee Assistance Program available 24/7

Paid Holidays & Paid Time Off

Employee Appreciation Days/Events

Job summary

Healthcare Outcomes Performance Co. (HOPCo) is hiring an Insurance Follow-Up Representative in Jacksonville, FL. This full-time role involves ensuring proper reimbursement for patient accounts by managing interactions with insurance companies and resolving denials.

Ideal candidates will have at least two years of medical claims processing experience and strong computer skills, including proficiency in Windows programs. A robust benefits package, including competitive health benefits and a 401k plan, is provided.

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.

Responsibilities

• Review insurance denials to determine and take appropriate action steps.
• Appeal claims that have been denied for no authorization or medical necessity.
• Verify receipt of claims with insurance plans to ensure timely reimbursement.

Skills

Medical claims processing

Understanding Explanation of Benefits

Advanced computer knowledge

Experience with Blue Cross/Blue Shield

Job description

NON-CLINICAL | BUSINESS OFFICE | FULL-TIME | JACKSONVILLE, FL | BENEFITS PACKAGE

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

Responsibilities

• 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.
• Communicate 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.

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 Workers Compensation carriers.

Benefits

At Southeast Orthopedic Specialists, we are dedicated to taking care of you so you can take care of business! Our robust Benefits Package includes the following:

• Competitive Health & Supplemental Benefits
• 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!