Minimum Qualifications
- Minimum two to three years of experience in medical billing.
- Must be able to communicate effectively with physicians, patients, and the public and be capable of establishing good working relationships with both internal and external customers.
- HSD/GED
Preferred
- Knowledge of computer systems. Experience with GE patient management system p
- Knowledge of the physician billing processes, ICD-10, and CPT coding.
Essential Functions
- Reviews insurance denials and rejections to determine the next appropriate action steps and obtain the necessary information to resolve any outstanding denials/rejections.
- Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
- Verifies receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims maximum reimbursement.
- Researches all information needed to complete the billing process including obtaining information from providers, ancillary services staff, and patients.
- Obtains and attaches referrals/authorizations to appointments/charges.
- Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards.
- Assumes full responsibility for reducing the accounts receivable of insurance balances by working through outstanding accounts.
- Analyzes account for proper claims processing and payment posting through inquiries from patients or staff.
- Identifies and communicates trends and/or potential issues to the management team.
- Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.
About us
The Center for Orthopedic Research and Education, We don't mean to brag but did you know The CORE Institute has been ranked by Ranking Arizona: The Best of Arizona Businesses!?
• #1 for Orthopedic Practices
• #1 for Healthiest Healthcare Employers
• #3 for Best Healthcare Workplace Culture
• Winner in Best Places to Work
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