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Insurance Follow-Up Representative
Southeast Orthopedic Specialists
Jacksonville, KSA
Full Time
Entry
Onsite
4 weeks ago
Medical Claims ProcessingInsurance Denial ManagementAppealsAccounts ReceivableMicrosoft OfficeCommunication
Free
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Medical Claims ProcessingInsurance Denial ManagementAppeals
About the Role
Southeast Orthopedic Specialists is seeking an Insurance Follow-Up Representative to review insurance denials, appeal claims, verify receipt of claims, and reduce accounts receivable.
Key Skills for This Role
Medical Claims ProcessingInsurance Denial ManagementAppealsAccounts ReceivableMicrosoft OfficeCommunication
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
Requirements
- 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
Full Job Posting
Overview
- Southeast Orthopedic Specialists is a regional leader in musculoskeletal medicine.
- Insurance Follow Up Representative position in the Central Business Office in Jacksonville, FL.
- Full time, non clinical role.
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.
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
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