Billing Specialist

At HOPCo, 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
• HSA with qualifying HDHP plans with company match
• 401k plan after 6 months of service with company match (Part-time employees included)
• Employee Assistance Program that is available 24/7 to provide support
• Employee Appreciation Days
• Employee Wellness Events

QUALIFICATIONS

• High school diploma/GED or equivalent working knowledge preferred.
• Minimum of two to three years of experience in medical billing.
• Prior experience working on claim errors in a claims management system preferred.
• Must have strong knowledge of resolution to payor edit reports, and reconciliation of clearinghouse and payor acceptance reports.
• Candidates with knowledge of ANSI formatting preferred.

ESSENTIAL FUNCTIONS

• Responsible for working claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers.
• Review and prepare claims for manual and/or electronic billing submission.
• Reviews insurance rejections to determine the next appropriate action steps and obtain the necessary information to resolve any outstanding rejections.
• Correct and identify billing errors and resubmit claims to insurance carriers.
• Update CAS segments on secondary electronic claims as needed.
• 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 step.
• Researches all information needed to complete the billing process including obtaining information from providers, ancillary services staff, and patients.

The Billing Specialist is responsible for the facilitation of patient billing and collection activities, following patient accounts through the billing process to the payor, working with the payor through claims processing, and ensuring reimbursement to the practice.

Healthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.