Insurance Follow Up / Medical Biller

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, The CORE Institute, has been recognized as one of Arizona's best healthcare organizations, including rankings for orthopedic practices, healthiest healthcare employers, healthcare workplace culture, and best places to work.