Follow Up Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Manage electronic denials, paper denials, and unpaid claims reports to address denied or unpaid claims across various insurance carriers.

• Forward denied claims to appropriate departments for resolution.

• Amend and resubmit claims through clearinghouse portals and billing systems.

• Redirect rejected and denied claims to other departments when necessary.

• Recognize denial patterns and communicate them to the lead to assist in preventing future occurrences.

• Initiate cases and collaborate with clearinghouses when erroneous claim rejections are encountered.

• Examine denied claims for necessary corrections and resubmission.

• Utilize payer websites and online portals to investigate denied claims.

• Follow up with insurance carriers on unpaid claims after the designated claim age.

• Reach out to insurance companies via phone, portals, and email regarding claims denied in error or that need further information.

• Investigate claims through various online platforms and portals.

• Identify denial trends and issues with carriers and report findings to the lead.

• Handle appeals for denied claims.

⛳️ Requirements

• 1–2 years of experience in Accounts Receivable Follow-Up.

• Experience in Professional CMS 1500 Billing.

• Familiarity with multiple clearinghouses, billing systems, and Electronic Medical Records (EMRs).

• Understanding of billing requirements across multiple states.

• Knowledge of both commercial and government payers.

• Basic knowledge of medical billing.

• Understanding of health insurance carrier billing and reimbursement policies.

• Strong problem-solving and dispute resolution capabilities.

• Ability to manage multiple tasks and adapt to evolving regulations.

• Excellent verbal and written communication skills.

• Superior organizational and time-management skills.

• Proficiency in Microsoft Office applications, including Teams, Outlook, and Excel.

• Capability to prioritize tasks effectively.

• Keen attention to detail.

• Reliable internet access.

• Ability to remain seated for extended periods while working at a desk or computer.

• Regular use of a keyboard, mouse, and other computer peripherals.

🏝️ Benefits

• 100% remote work.

• Designated home office or other quiet and secure workspace.

• Reliable internet access for the remote workspace.