Insurance Follow-Up Specialist

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

📋 Description

• Conduct thorough investigations and swiftly resolve insurance claim denials, typically addressing 50 to 100 denials each day.

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

• Understand and apply LCD/NCD requirements while managing denials related to CPT/HCPCS.

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

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

• Utilize payer portals (such as NaviNet, Availity, Medicare portals, and others) along with clearinghouses to facilitate efficient claim submission.

• 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.

• Comprehensive knowledge of ICD-10, CPT, HCPCS, and the intricacies of payer policies.

• Practical experience with Medicare collections for specialty drug coverage, including the use of Medicare portals for filing determinations and appeals.

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

• Experience with Medicaid and other commercial insurance plans.

• Understanding of reimbursement regulations, managed care contracts, and strategies for resolving denials.

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

• Proficient in Microsoft Office Suite (Outlook, Teams, Excel, etc.).

• A collaborative team member with a proactive approach and a commitment to patient-centered outcomes.

🏝️ Benefits

• Comprehensive Healthcare – Medical, dental, and vision coverage, including prescription drug plans and telemedicine services.

• Flexible Savings Options – Choose from Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA) to manage healthcare costs.

• Supplemental Protection – Accident, critical illness, and hospital indemnity plans to provide additional financial security.

• Dependent Care FSA – Pre-tax savings for eligible childcare and dependent care expenses.

• 401(k) Retirement Plan – Secure your future with a competitive company match.

• Disability Coverage – Voluntary short-term and long-term disability plans to protect your income.

• Fertility and Family Support – Resources and benefits designed to support fertility care and family planning.

• Life and AD&D Insurance – Financial protection for you and your loved ones.

• Counseling and Wellness Support – Free resources to support emotional, physical, and financial well-being.

• Education Assistance – Tuition reimbursement and certification support to help you grow in your career.

• Continuing Education – Access to a CEU library for ongoing professional development.

• Charitable Giving and Volunteer Program – Matched donations and paid volunteer time off to support causes you care about.

• Employee Referral Bonus – Earn rewards for helping us find top talent.