Insurance Follow-Up Representative

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

📋 Description

• Oversee and manage outstanding Accounts Receivable while documenting follow-up actions.

• Address underpayments and denials through thorough root cause analysis and corrective measures.

• Bring attention to accounts and denial patterns to management and provider representatives for necessary contracting actions.

• Recognize trends in denials and underpayments that necessitate modifications in the computer system.

• Compile reports for discussions with provider representatives and senior leadership.

• Assess underpayments in relation to insurance carrier reimbursement guidelines and clinical/payment policies.

• Implement LVHN insurance contract stipulations when reviewing claim payments.

• Calculate and submit requests for adjustments and refunds, ensuring correct codes and documentation are included.

• Ascertain patient liability for non-covered services, co-pays, deductibles, and co-insurance while adhering to timely filing limits.

• Keep detailed logs of issues and account examples for meetings with insurance carriers.

• Review emails and correspondence within 24–48 hours, ensuring appropriate distribution of patient and insurance carrier mail.

⛳️ Requirements

• High School Diploma/GED is required.

• At least 2 years of experience in professional or facility billing and/or collections involving all major third-party payers, or relevant work experience in a healthcare setting.

• Strong follow-up and verification abilities.

• Exceptional verbal and written communication skills.

• Familiarity with insurance contracts and regulations.

• Proficient in Microsoft Excel, Word, and PowerPoint.

• Solid analytical, mathematical, and organizational skills.

• Completion of DOE and Revenue Cycle Education Training within 3 months of employment is required.

• An Associate’s Degree in Health Care Science, Business, or a related field is preferred.

• CPAT - Certified Patient Accounting Technician - State of Pennsylvania is preferred.

• Ability to lift and carry 25 lbs; frequent sitting, standing, and keyboard usage is required.

🏝️ Benefits

• Flexible remote work arrangement.

• Day shift hours.

• Monday to Friday work schedule, from 8:00 AM to 4:30 PM.

• Recognized as a Great Place to Work® certified employer.

• Commitment to equal opportunity employment.