Insurance Follow Up Specialist

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

📋 Description

• Initiate follow-up on outstanding, appealed, or unpaid insurance claims to facilitate maximum and prompt reimbursement.

• Submit appeals and reconsiderations for claim denials using practice management systems, payor portals, or traditional mail.

• Analyze daily claim rejections received from the clearinghouse.

• Screen claims for pre-authorization and request as well as submit relevant medical records.

• Collaborate with Coding, Payment Posting, Managed Care Operations, Provider Enrollment, and Clinical Operations to address claim issues.

• Review and respond to payor correspondence concerning recoupments, refunds, eligibility, or additional inquiries.

• Assist the customer service team with patient billing issues or disputes.

• Verify patient benefits and insurance eligibility.

• Conduct claims status verification and navigate insurance websites for payor guidelines.

• Communicate findings effectively to insurance companies, management, and clinical departments.

• Complete additional responsibilities as assigned.

⛳️ Requirements

• Some familiarity with patient billing or collection/reimbursement processes in a healthcare environment is preferred.

• Experience in medical claims follow-up tasks, specifically in processing insurance claim appeals for various payors.

• Detail-oriented, with the ability to organize, prioritize, and coordinate workload within time constraints while managing urgent requirements promptly.

• Capacity to multi-task in a fast-paced, high-volume setting.

• Proficient in Microsoft Office applications.

• Experience with EPIC software.

• Familiarity with Experian and TriZetto/Claim Logic.

• High School Diploma or equivalent.

• A minimum of three (3) years of experience in a hospital business office or related medical billing role.

• Knowledge of claims reimbursement processes.

🏝️ Benefits

• UT SELECT Medical insurance provided at no cost for employees.

• Family medical coverage available through payroll deductions.

• Discounted copays and coinsurance through UT Health Physicians.

• $50,000 group term life insurance offered at no charge.

• $50,000 basic accidental death and dismemberment insurance provided free of charge.

• Options for purchasing additional employee and dependent life and AD&D coverage at group rates.

• Three dental insurance plan options through Delta Dental, including two PPOs and one HMO.

• Two vision plan options with either standard or enhanced benefits.

• Disability insurance available.

• Flexible spending accounts for dependent care and healthcare expenses.

• Participation in the Teacher Retirement System (TRS) or Optional Retirement Plan (ORP).

• Voluntary retirement programs with five retirement plan providers.

• Front-loaded paid time off ranging from 128 to 208 hours (16 to 26 days) based on years of service.

• Extended Illness Bank accrues at a rate of 8 hours per month.

• Paid Family Leave up to 240 hours (6 weeks) after six months of consecutive employment.

• Twelve paid holidays each year.

• Discounts available for services, tickets, and gym memberships.