Insurance A/R Follow Up Specialist

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

📋 Description

• Conduct high-volume outbound calls to insurance carriers to follow up on outstanding, unpaid, and underpaid claims.

• Verify claim status on aging accounts and accurately document outcomes in the billing system after each call.

• Determine the reasons for non-payment—whether due to processing delays, missing information, denials, or errors on the payer side—and take the necessary next steps.

• Request claim reprocessing, corrections, or reconsiderations directly with insurance representatives when applicable.

• Navigate payer phone systems, hold queues, and communicate with insurance representatives in a professional and persistent manner.

• Escalate complex or unresolved accounts to the billing team, providing comprehensive documentation of call history and payer responses.

• Identify denial reason codes and document them clearly for each impacted claim.

• Collect information from payers needed to address denials, including missing documentation requirements, coordination of benefits issues, or eligibility discrepancies.

• Relay denial findings to the billing team so that appropriate corrective actions—resubmissions, appeals, or patient billing—can be taken.

• Monitor recurring denial patterns and report trends to the billing manager.

• Keep accurate and up-to-date call logs and notes for every insurance follow-up interaction.

• Document payer responses, reference numbers, representative names, and promised payment dates for all calls.

• Update claim statuses in the billing system in real-time to keep the billing team informed.

• Systematically manage assigned aging buckets, prioritizing by dollar amount, payer deadlines, and days outstanding.

• Track promised payment timelines and re-engage payers if commitments are not met.

• Collaborate closely with the existing medical billing team to understand claim priorities and receive guidance on which accounts require immediate attention.

• Communicate daily progress on assigned accounts and flag any issues that need the billing team's action.

• Provide the billing manager with regular updates on call volume, outcomes, and any payer issues that require escalation.

⛳️ Requirements

• Prior experience in making insurance follow-up calls within a medical billing or healthcare revenue cycle environment — this is a mandatory requirement.

• Comfortable with making a high volume of outbound calls to insurance companies on a daily basis.

• Familiarity with common denial reason codes, payer responses, and insurance claim adjudication processes.

• Possess a professional and persistent phone presence — able to endure hold times, communicate clearly with representatives, and remain determined until an actionable answer is obtained.

• Strong documentation practices — ensuring every call is logged accurately and completely before proceeding to the next one.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• Opportunities for professional development and career advancement.

• A supportive and collaborative work environment.