Insurance Coordinator

Description

Are you passionate about serving patients in an inspiring work environment alongside talented people? Get moving with OCR! With over 50 years in business, we are the premier provider of orthopedic care in Colorado, Wyoming, and Nebraska. Our organization continues to grow and we are looking for individuals who share our mission.

The Insurance Coordinator primarily manages all aspects of assigned insurance carriers, including data entry for practice/surgery charges, delivering receipts for patients with insurance, and researching rejected claims to determine an internal procedure for correcting, refiling and follow-up. This position is also responsible for communicating changes in insurances policies, maintaining up-to-date reference materials and ensuring compliance with all insurance rules and regulations. The Insurance Coordinator must have the ability to meet with patients regarding insurance benefits and eligibility as well as implementing external training programs for patients. They maintain accounts receivable aging and routinely audit claims while performing aggressive collection work where necessary.

Essential Duties and Responsibilities

• Follows up on denials, claim suspensions, and severe reductions in reimbursement promptly, exercise all options to obtain payment.
• Maintains up-to-date reference materials on respective insurance rules and regulations and obtains a concise understanding of these regulations for assigned insurance carriers to ensure complete compliance with all insurance rules and regulations for assigned insurance carriers.
• Communicates changes in respective insurance policies to supervisor for dissemination to other staff.
• Responsible for maintaining positive accounts receivable for assigned insurance carriers. Demonstrates consistent and complete resolution collection work on primary and secondary claims.
• Identifies accounts for outside collection on a timely basis and prepares appropriate paperwork for physician-decision and submission to a collection agency, if applicable.
• Obtains a general understanding of insurance carriers assigned to other insurance coordinators and communicates changes and/or adjustments needed.
• Meets with patients regarding insurance benefits and eligibility prior to surgery as well as outstanding patient balances.
• Establishes payment arrangements for patients per guidelines established by the supervisor and follow department protocol for approving arrangements outside of established guidelines.
• Prepares adjustments, as needed, to accounts for assigned insurance carriers and submits to the supervisor for approval, for processing weekly.
• Accepts primary responsibility for answering the business phone outside line.
• Communicates all concerns, risk management issues, breakdown in protocol and constructive criticisms to supervisor. Follows chain-of-command established by supervisor when addressing protocol issues outside of business office department.

Requirements

• High school diploma or equivalent is required.
• Minimum one year experience in the insurance or medical industry or equivalent experience with collections in a business/accounting department.
• Knowledge of medical terminology preferred.
• Core competencies in quality, detail oriented, communication, teamwork, and confidentiality.

Physical Requirements

• The work environment is the typical office environment. The employee must be able to complete their work satisfactorily in an environment where there are significant distractions, including staff, patients, and vendors walking through and conversing, telephones ringing, conversations carrying over, loud noises, and interruptions to answer questions from others.
• While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feel objects, tools, or controls for up to 8 hours per day. The employee frequently is required to talk or hear. The employee is occasionally required to stand; walk; reach with hands and arms, and stoop, kneel, crouch, or crawl.
• The employee will occasionally lift and/or move up to 25 pounds and should do so in a sound and safe manner. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Benefits:

• Medical, Dental, & Vision coverage
• Life and AD&D Insurance
• Short- and Long-term disability coverage
• Retirement savings and profit sharing plan participation
• Employee Assistance Program
• Paid Holidays & Paid Time Off
• Company-sponsored events
• Annual merit increases

*Benefit eligibility is dependent on employment s