Patient Account Representative - Orthopedics Insurance Collections (BCBS)

Dedicated to serving northeast Oklahoma’s bone, joint, and muscle needs, our specialty-trained doctors at Advanced Orthopedics of Oklahoma deliver the expert, compassionate care needed to heal, recover, and advance.

We proudly offer the highest level of comprehensive care for a variety of musculoskeletal concerns, from chronic pain to acute injuries, to area residents throughout Tulsa, Claremore, Bixby, McAlester, and the surrounding areas.

Job Summary: Review and follow-up of charges billed to insurance carriers. This includes contacting insurance companies, researching and re-filing claims, resolving patient billing problems. Shared responsibility for answering patient and insurance calls, printing, reviewing, and mailing demand claims and statements as needed.

Essential Functions and Responsibilities:

Generates and prints insurance claims, both paper and electronic.

Files primary, secondary and tertiary insurance claims per office protocol.

Processes requests for additional information.

Researches, corrects, and refiles all claim denials due to incorrect or missing information.

Follows-up on accounts where insurance payment is pending.

Answers patient questions and inquiries regarding their accounts and follows through on requests.

Works cooperatively with others to increase accuracy and efficiency.

Posts all actions and maintains permanent record in patient account or other appropriate place.

Prepare and submit account adjustments.

Call Insurance companies, hospitals, and referring physician offices to resolve payment problems.

Assists other departments as requested by supervisor.

Attends meetings as required.

Maintains strictest confidentiality.

Work claim dashboard from eCW.

Secure authorizations not properly obtained before services rendered.

Research and prepare refund requests for insurance and patient reimbursement.

Write up and file appeals to insurance as needed.

Performs other duties as assigned.

Education:

High school diploma or GED required.

Work Experience:

One year of insurance and collection experience in a health care organization.

Licensure, Registration and/or Certification: None.

Knowledge, Skills, and Abilities:

Knowledge of medical billing and collection practices.

Knowledge of basic medical coding and terminology.

Knowledge of grammar, spelling, and punctuation.

Experience with computer, fax, calculator, and copier.

Ability to read, understand and follow oral and written instructions.

Ability to communicate professionally, clearly, and courteously with patients, co-workers, and others.

Ability to establish and maintain effective working relationships with physicians, staff, and the public.

Ability to sort and organize materials.

Ability to write legibly.

Working Conditions:

Work is performed in a medical office setting.

May be exposed to communicable diseases, toxic substances, ionizing radiation, medical preparations, biohazards, bodily fluids and other conditions common to a clinic setting.

Involves frequent contact with staff and the public.

Contact involves dealing with sick persons.

Interaction with others may be constant and interruptive.

Work may be stressful at times.

May involve dealing with angry or upset individuals.

May periodically work outside of normal work hours.

Physical Requirements:

Requires sitting for long periods of time.

Requires viewing computer screen and typing for long periods.

Requires normal physical strength to exert up to 30 pounds of force occasionally and/or up to 10 pounds of force frequently to move objects.

Requires normal physical agility, which includes stooping, bending and stretching to access files and supplies.

Requires normal concentration regarding complexity and timeliness of decision making.

Requires normal memory, taking into consideration the amount and type of information involved.

Average visual acuity necessary to prepare or review documents or operate equipment.

Ability to speak, frequently conveying detailed or important information or ideas accurately.

Ability to hear normal speech, both in person and on the telephone.

Job Type: Full-time

Benefits:

401(k)

401(k) matching

Dental insurance

Employee assistance program

Flexible schedule

Flexible spending account

Health insurance

Health savings account

Life insurance

Paid time off

Referral program

Vision insurance

Application Question(s):

What is your salary expectation?

Do you have experience appealing denied medical claims?

Do you have Blue Cross Blue Shield (BCBS) experience?

Experience:

insurance collections: 1 year (Preferred)

Work Location: In person