Healthcare Outcomes Performance Co. (HOPCo)

Billing/Collections Specialist

Healthcare Outcomes Performance Co. (HOPCo)  •  Royal Palm Beach, FL / Wellington, FL (Onsite)  •  15 days ago
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Job Description

Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise.

Center for Bone & Joint Surgery of the Palm Beaches offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy.

As Center for Bone & Joint Surgery of the palm Beaches continues to grow, we are looking for a Billing/Collections Specialist Please see below for the functions and requirements for this position.

ESSENTIAL FUNCTIONS

  • Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards.
  • Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers.
  • Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.
  • Updates and confirms as necessary to allow processing of claims to insurance plans.
  • Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
  • Attaches referrals/authorizations to appointments/charges if available.
  • Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
  • Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines.
  • Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement.
  • Identifies and communicates trends and/or potential issues to management team.
  • Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office.
  • Other duties as assigned by leadership.
  • 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.

At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:

  • Competitive Health & Welfare Benefits
  • Monthly $43 stipend to use toward ancillary benefits
  • HSA with qualifying HDHP plans with company match
  • 401k plan with company match
  • Employee Assistance Program that is available 24/7 to provide support
  • Paid Time Off
  • Paid Holidays
  • Mileage reimbursement
  • and more...

#CBJ

Healthcare Outcomes Performance Co. (HOPCo)

About Healthcare Outcomes Performance Co. (HOPCo)

Healthcare Outcomes Performance Company (HOPCo) is the leading provider of musculoskeletal value-based health outcomes management, service line management and practice management. This includes comprehensive management and optimization of specialties such as orthopedics, spine, hand, pain management, rehabilitation and neurology.

HOPCO’s integrated care and analytics platform has proven to increase the quality of patient care and program revenue while reliably reducing the total cost of care across the care continuum for practices, health systems and payors alike.

HOPCo’s affiliated payors, practices and health systems successfully participate in highly efficient value-based contracting (bundled payments, capitated population health programs, and other risk-based arrangements) utilizing HOPCo’s proprietary platforms, IT solutions, integrated analytics, and standardized care pathways. This helps our partners obtain real time, actionable insights into their systems, allowing them to comprehensively manage the entire business while improving outcomes for their treasured patients.

As a result, HOPCo has become the only organization with proven and sustainable success in population health management of musculoskeletal specialty care.

Industry
Healthcare & Social Services
Company Size
201-500 employees
Headquarters
Phoenix, AZ
Year Founded
2000
Website
hopco.com
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