Insurance Follow-Up Specialist

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

📋 Description

• Perform comprehensive analysis and follow-up on pending commercial and government insurance claims.

• Investigate and address claim denials, rejections, and underpayments through billing corrections, appeals, and resubmissions.

• Prepare and submit Explanation of Benefits (EOBs), detailed statements, medical records, and additional claim documentation.

• Address inquiries from payers and patients concerning overdue claims.

• Utilize payer portals, Electronic Health Records, and patient accounting systems to check claim status, document notes, and oversee follow-up activities.

• Recognize trends in denial and payment delays, contributing to initiatives aimed at process improvement.

• Maintain precise account activity records while adhering to production and quality benchmarks.

• Communicate effectively with insurance representatives, patients, and internal teams to resolve outstanding issues.

• Manage daily tasks effectively in a dynamic, high-volume environment.

• Offer assistance on special projects and additional assignments as requested by management.

⛳️ Requirements

• A minimum of 2 years of prior experience dealing with commercial or other third-party insurance claims, as well as medical billing and follow-up.

• Familiarity with various forms, CPT and ICD codes, insurance terminology, and insurance company remittance advice.

• Experience with Meditech is preferred but not mandatory.

• Experience with BCBS is advantageous.

• Certificates, licenses, registrations, and/or Medicare certification are beneficial, although not required.

🏝️ Benefits

• Fully remote work.