Insurance A/R Follow-Up Specialist

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Oversee the insurance claims process and actively follow up on outstanding accounts receivable.

• Identify and address claim denials.

• Appeal claims that are underpaid or denied.

• Liaise with insurance companies and patients to ensure timely reimbursement.

• Leverage insurance billing practices, coding, and reimbursement regulations to enhance revenue cycle management and reduce revenue loss.

• Post charges for services promptly.

• Submit accurate claims electronically to carriers.

• Review and manage clearinghouse reports.

• Verify patient eligibility and benefit coverage.

• Investigate and analyze insurance denials, updating accounts as necessary.

• Prepare and submit secondary claims as required.

• Address inquiries regarding deductibles, co-insurance, and co-pays.

• Draft and submit appeal letters to insurance providers.

• Recommend necessary coding adjustments.

• Conduct soft collections when required.

• Scrub Aged Trial Balance Reports for insurance discrepancies.

• Provide training to team members as needed.

• Review denial reports, update accounts, and resolve issues related to denials.

• Generate reports on bad debt submissions and PFC Medicaid eligibility.

• Support internal auditing efforts.

• Execute other tasks as assigned by management.

⛳️ Requirements

• Proficient in electronic medical records (EMR).

• Precision in billing is essential to prevent errors and secure proper reimbursement.

• Capable of working independently.

• Familiarity with medical billing software (e.g., Kareo, AdvancedMD) and electronic health records (EHR) systems is preferred.

• Knowledge of medical terminology, anatomy, and healthcare processes.

• Strong verbal and written communication skills for effective interaction with colleagues, patients, and insurance companies.

• Ability to resolve billing discrepancies and manage claim denials effectively.

• Skilled in handling multiple tasks and meeting deadlines efficiently.

• A minimum of two years of experience in accounts receivable, medical billing, or a related field is required.

• A total of 3-5 years of experience is mandatory.

• High School Diploma/GED is required.

• An associate’s degree in medical billing, health information management, or a related field is advantageous.

• Certification as a Certified Professional Biller (CPB) or Certified Coding Specialist (CCS) is preferred.

• Commitment to ongoing education to remain updated on changes in billing codes and regulations.

• Familiarity with the local healthcare landscape, including major insurers and healthcare providers, is preferred.

🏝️ Benefits

• 401(k)

• 401(k) matching

• Dental insurance

• Health insurance

• Paid time off

• Paid training

• Tuition reimbursement

• Vision insurance