Insurance Follow-up Denial Specialist I

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

📋 Description

• Timely processing of insurance and billing claims

• Review of electronic claims and submission reports

• Resolution and resubmission of rejected claims

• Collaboration with Medical Records, Coding, Revenue Integrity, Patient Access, and Patient Financial Services to rectify claim errors

• Management of daily error logs, stalled reports, aging claims, and ad-hoc reports

• Response to insurance company requests for additional information and billing status inquiries

• Coordination with insurance payers to ensure accurate billing for assigned patient accounts

• Maintenance of daily follow-up reports while addressing denials and underpayments

• Support for Customer Service with patient inquiries and concerns

• Preparation of correspondence to payers and patients regarding claim status and required additional information

• Review of account documentation to determine necessary actions for correct billing

• Initiation of billing procedures along with appropriate follow-up or collection actions

• Documentation of billing, follow-up, collection, and escalation efforts

• Processing of administrative and medical appeals, refunds, reinstatements, and insurance claim rejections under supervision

• Communication with team members concerning assigned projects and process education

• Monitoring and aiding team members, providing feedback, assisting with training, auditing work, and conveying progress

• Offering ongoing education about processes and accounts-receivable requirements

• Verification of caller authorization levels and relevant information in compliance with HIPAA

⛳️ Requirements

• Ability to work with advanced billing procedures

• Capacity to prioritize and multitask based on workload volume and deadlines

• Understanding of Revenue Cycle connections among Charge Capture, Patient Access, HIM, Coding, and Patient Financial Services

• Familiarity with coverage, payment, compliance, and basic billing rules for Government and Managed Care payers

• Competence in handling confidential personnel and patient-related information with discretion

• Skill in giving and following written and verbal instructions

• Proficient in personal computer applications

• Expertise in Word, Excel, and PowerPoint

• Professional and effective verbal and written communication in English

• Ability to collaborate with all departments and levels of management

• Minimum of one year experience in a Revenue Cycle Department or related fields such as registration, finance, collections, customer service, medical, or contract management

• High school diploma or GED

• Knowledge of and compliance with HIPAA regulations

🏝️ Benefits

• No explicit benefits or compensation extras stated