Insurance Follow-Up Representative
Healthcare Outcomes Performance Co. (HOPCo), Jacksonville, FL, United States
Established in 2001, Southeast Orthopedic Specialists is a regional leader in musculoskeletal medicine. We are dedicated to growing with our patients and expanding our reach to meet current and future needs, delivering industry‑leading five‑star orthopedic care to as many people as possible.
Non‑clinical | Business Office | Full‑time | Jacksonville, FL | Benefits package
Insurance Follow‑Up Representative – Central Business Office, Jacksonville, FL Insurance Follow‑Up Representatives are responsible for following patient accounts through the insurance payors to ensure proper reimbursement to the practice.
Responsibilities
Review insurance denials and determine the next appropriate action steps to receive payment from the payor.
Appeal claims that have been denied for no authorization, lack of medical necessity, or other reasons.
Verify receipt of claims with insurance plans to ensure timely 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
Minimum two years of medical claims processing experience.
Ability 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
Competitive health and supplemental benefits.
Monthly stipend for ancillary benefits.
HSA with qualifying HDHP plans with company match.
401(k) plan.
Employee assistance program available 24/7.
Employee appreciation days/events.
Paid holidays and paid time off.
And more!
At Southeast Orthopedic Specialists, we are dedicated to taking care of you so you can take care of business.
#J-18808-Ljbffr
Non‑clinical | Business Office | Full‑time | Jacksonville, FL | Benefits package
Insurance Follow‑Up Representative – Central Business Office, Jacksonville, FL Insurance Follow‑Up Representatives are responsible for following patient accounts through the insurance payors to ensure proper reimbursement to the practice.
Responsibilities
Review insurance denials and determine the next appropriate action steps to receive payment from the payor.
Appeal claims that have been denied for no authorization, lack of medical necessity, or other reasons.
Verify receipt of claims with insurance plans to ensure timely 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
Minimum two years of medical claims processing experience.
Ability 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
Competitive health and supplemental benefits.
Monthly stipend for ancillary benefits.
HSA with qualifying HDHP plans with company match.
401(k) plan.
Employee assistance program available 24/7.
Employee appreciation days/events.
Paid holidays and paid time off.
And more!
At Southeast Orthopedic Specialists, we are dedicated to taking care of you so you can take care of business.
#J-18808-Ljbffr