The Center for Orthopedic Research and Education, The CORE Institute®, began practicing in 2005 to deliver comprehensive orthopedic care, one patient at a time. Our fellowship-trained physicians provide specialized care in the areas of surgical, non-surgical and rehabilitative hip, knee, shoulder, elbow and ankle procedures, joint replacement, sports medicine, arthroscopy, fracture management, orthopedic traumatology, hand and wrist procedures, complex articular cartilage restoration, musculoskeletal oncology, foot and ankle reconstruction, physical medicine and rehabilitation, comprehensive spine care and pain management. The CORE Institute team is dedicated to providing technologically advanced surgical techniques and rehabilitation in six locations in Arizona and Michigan. With state-of-the-art research labs, less-invasive surgery, on-site MRI and physical therapy, we truly provide excellence in patient care. If you would like to be part of a dedicated, dynamic healthcare team in a challenging, rewarding environment, this is the place for you!
As The CORE Institute continues to grow, we are currently seeking a full-time Insurance Follow-Up Representative to join our team of professionals at our North Phoenix location.
GENERAL STATEMENT OF DUTIES:
Responsible for facilitation of patient billing and collection activities, following patient accounts through the billing process to the payor, working with the payor through claims processing, ensuring reimbursement to the practice. 1. Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections. 2. Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans. 3. Verifies receipt of claim with insurance plans, determining the next appropriate action step. 4. Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients. 5. Obtains and attaches referrals to appointments/charges. 6. Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement from insurance payers. 7. Assumes full responsibility of reducing the accounts receivable of insurance balances by working through outstanding accounts. 8. Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff. 9. Communicates with insurance and collection agencies. Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement. 10. Identifies and communicates trends and/or potential issues to management team. 11. Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office. 12. The job holder must demonstrate current competencies for job position.