Healthcare Outcomes Performance Co. (HOPCo)

Insurance

• 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.

Insurance Follow-Up Representative