Insurance Follow-Up Specialist

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

📋 Description

• Conduct research to address denied, unpaid, underpaid, or inaccurately processed insurance claims.

• Investigate claim denials and rejections by reaching out to insurance providers and examining payer requirements.

• Follow up with Medicare, Medicaid, Blue Cross, and other commercial insurance providers to acquire updates on claim statuses and payment resolutions.

• Analyze denial codes, remittance advice, payer communications, and claim documentation to identify underlying causes and outline subsequent actions.

• Rectify claim inaccuracies and facilitate claim resubmissions to ensure prompt reimbursement.

• Prepare and submit appeals, reconsiderations, amended claims, and associated documentation.

• Manage the inventory of assigned claims and prioritize accounts to minimize aging accounts receivable.

• Reach out to patients to gather or confirm information necessary for resolving billing or insurance problems.

• Review and refresh patient demographics, insurance details, and account information.

• Accurately and promptly document account activities, payer interactions, and claim resolutions.

• Communicate with insurance companies, patients, and client representatives regarding outstanding claims and balances.

• Identify trends in denials and relay findings to leadership and operational teams.

• Achieve productivity, quality, and cash collection performance benchmarks.

• Ensure compliance with HIPAA regulations, client specifications, and company policies.

• Collaborate with Billing, Claims, Collections, and Client Services teams to address intricate reimbursement challenges.

⛳️ Requirements

• High School Diploma or GED.

• 2+ years of experience in insurance follow-up, denials management, medical billing, or healthcare collections.

• Familiarity with Medicare, Medicaid, and commercial payers.

• Understanding of patient billing, claims submission, and denial resolution processes.

• Proficient in Microsoft Office (Outlook, Word, and Excel).

• A secure and private workspace at home.

• A reliable wired (preferred) high-speed internet connection.

• Minimum internet speeds of 30 Mbps for download and 10 Mbps for upload.

• Ability to maintain a professional and distraction-free work environment during scheduled working hours.

• Legally authorized to work in the United States at the time of hire.

• Employment visa sponsorship is not available.

• Successful completion of a pre-employment background check.

• Candidates residing in New York are not eligible for consideration.

🏝️ Benefits

• Medical, Dental & Vision coverage.

• 401(k) plan with Company Match.

• Paid Wellness Time & Holidays.

• Employer-Paid Life Insurance & Long-Term Disability.

• Paid Training opportunities.

• Internal Growth Opportunities available.

• Work-from-home arrangement.

• Video interviews may be recorded and transcribed for candidate evaluation purposes.

• A pre-employment background check will be conducted.