Insurance Follow-Up Representative
Healthcare Outcomes Performance Co. (HOPCo)
full-time
Posted on:
Location Type: Remote
Location: Florida • United States
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About the role
- 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.
Requirements
- 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.
Benefits
- 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!
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical claims processingclaims appealsaccounts receivable managementclaim denial analysisdiscrepancy resolutiontimeliness verificationinsurance reimbursementEOB interpretationWindows-based programsExcel
Soft Skills
communicationproblem-solvingattention to detailorganizational skills