Insurance Follow-Up Specialist

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

📋 Description

• Investigate and resolve insurance claim denials, handling typically between 50 to 100 denials each day.

• Collaborate with payers to address issues and ensure prompt reimbursement.

• Interpret LCD/NCD requirements while managing CPT/HCPCS-related denials.

• Work alongside front desk and authorization teams to minimize delays and enhance collections.

• Offer phone support to patients, insurance providers, and internal teams.

• Utilize payer portals such as NaviNet, Availity, Medicare portals, and other clearinghouses.

• Provide timely and compliant follow-up to achieve revenue cycle objectives.

⛳️ Requirements

• Over 5 years of experience in healthcare billing, claims, or insurance follow-up.

• In-depth understanding of ICD-10, CPT, HCPCS, and the nuances of payer policies.

• Practical experience with Medicare collections focused on specialty drug coverage.

• Familiarity with using Medicare portals for filing determinations and appeals.

• Demonstrated success in collections with Blue Cross payers; experience with BCBS FL, Independence BC, and BCBS TX is preferred.

• Proficient in Medicaid and other commercial insurance plans.

• Knowledge of reimbursement regulations, managed care contracts, and strategies for denial resolution.

• Detail-oriented with strong analytical and critical thinking abilities.

• Skilled in Microsoft Office Suite, including Outlook, Teams, and Excel.

• Team-oriented with a proactive approach and a commitment to patient-centered outcomes.

• Candidates must reside in the United States.

🏝️ Benefits

• 401(k) retirement plan featuring a competitive company match.

• Comprehensive medical, dental, and vision coverage, which includes prescription drug plans and telemedicine services.

• Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA) are available.

• Policies for accident, critical illness, and hospital indemnity.

• Dependent Care Flexible Spending Account (FSA).

• Optional short-term and long-term disability plans.

• Resources and benefits for fertility and family support.

• Life and Accidental Death & Dismemberment (AD&D) insurance.

• Access to free counseling and wellness resources to support emotional, physical, and financial well-being.

• Tuition reimbursement and support for certification.

• Continuing Education Unit (CEU) library for ongoing professional growth.

• Contributions to matched charitable donations and provision for paid volunteer time off.

• Employee referral bonuses.

• Fully remote work option available.

• Optional hybrid or in-office work for local employees.

• Emphasis on work-life balance and a supportive culture.