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

• Examine claim rejections and denials by liaising with insurance carriers and reviewing payer requirements

• Follow up with Medicare, Medicaid, Blue Cross, and various commercial insurance providers to acquire claim status updates and payment resolutions

• Analyze denial codes, remittance advice, payer correspondence, and claim documentation to pinpoint root causes and establish next steps

• Rectify claim errors and facilitate the resubmission of claims

• Prepare and submit appeals, reconsiderations, corrected claims, and accompanying documentation

• Manage the assigned claim inventory and prioritize accounts to minimize aging accounts receivable

• Contact patients to gather or confirm information necessary for resolving billing or insurance issues

• Review and update patient demographics, insurance details, and account information

• Accurately and promptly document account activity, payer communications, and claim resolutions

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

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

• Achieve productivity, quality, and cash collection performance standards

• Ensure compliance with HIPAA regulations, client requirements, and company policies

• Collaborate with Billing, Claims, Collections, and Client Services teams to resolve intricate reimbursement issues

⛳️ 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 applications, including Outlook, Word, and Excel

• Secure and private workspace within the home

• Reliable high-speed internet connection (wired preferred)

• Minimum internet speed of 30 Mbps for download and 10 Mbps for upload

• Professional and distraction-free work environment during scheduled hours

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

• Capacity to complete video interviews, which may be recorded and transcribed

• Ability to provide an internet speed test during the interview process if requested

• Successful completion of a pre-employment background check

• Candidates residing in New York are not eligible for this position

🏝️ Benefits

• Medical, Dental & Vision

• 401(k) with Company Match

• Paid Wellness Time & Holidays

• Employer-Paid Life Insurance & Long-Term Disability

• Paid Training

• Opportunities for Internal Growth