Insurance Follow-Up Rep / Medical Collector

• Reviews insurance denials and rejections to determine next appropriate action steps and obtain 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 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 of reducing the accounts receivable of insurance balances by working through outstanding
accounts.
• Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff.
• Identifies and communicates trends and/or potential issues to management team.
• Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.

EXPERIENCE
• Minimum one to three years of experience in medical billing and collections.
• Must be able to communicate effectively with insurance carriers and patients and be capable of establishing good
working relationships with both internal and external customers.

KNOWLEDGE
• Knowledge of the physician billing processes ICD-10 and CPT coding.
• Knowledge of computer systems. Experience with Athena billing & collections preferred.
• Advanced computer knowledge, including Window based programs.

SKILLS
• Skill in customer service and an understanding of The HOPCo code of conduct and culture.
• Skill in using computer programs and applications including Microsoft Excel, Microsoft Word and Outlook.
• Skill in establishing good working relationships with both internal and external customers.

ABILITIES
• Ability to multi task in a fast-paced environment. Must be detailed oriented with strong organizational skills.
• Ability to understand patient demographic information and determine insurance eligibility.
• Ability to work independently and demonstrate the ability to analyze data.

ENVIRONMENTAL WORKING CONDITIONS
• Normal office environment.

PHYSICAL/MENTAL DEMANDS
• Requires sitting and standing associated with a normal office environment.
• Combination of bending, lifting and transferring activities.
• Manual dexterity using a calculator and computer keyboard.

ORGANIZATIONAL REQUIREMENTS
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills,
abilities and working conditions may change as needs evolve.