Insurance Follow-up Specialist

Summary

The Insurance Follow-up Specialist works financial classes assigned by the supervisor. This involves working from reports and contacting the insurance companies to inquire as to why the claim was not paid correctly, the reason for denials, sending appeals, or claims not paid in a timely manner. This position allows for a hybrid work schedule.

Primary Responsibilities

• Check accounts online or call insurance companies for claim status, payments or denials.
• Utilize multiple billing software to obtain claim resolution and resubmit corrected claims.
• Confirm claim accuracy according to client contracts/agreements and Governmental/State fee schedules.
• Process online adjustments, voids, claim reconsiderations when applicable.
• Check patient eligibility online.
• Appeal claims that have been incorrectly denied.
• Document all steps taken for account resolution on each account worked.
• Work correspondence as assigned.
• Contact patients when necessary for insurance information; if no contact, send letters.
• Report denial and negative payment trends to Team Lead.
• Answer incoming calls and return voice messages.
• Responsible for maintaining and reporting daily productivity.
• Assist other team members when necessary.
• Overtime and remote work as necessary dependent upon work necessity.
• Other related duties as necessary

Position Type

Non-exempt.

Knowledge and Skill Requirements

• Problem-solving— identifies and resolves problems in a timely manner, gathers and analyzes information skillfully.
• Oral communication— speaks clearly and persuasively.
• Planning/organizing— prioritizes and plans work activities and uses time efficiently.
• Quality control— demonstrates accuracy and thoroughness and monitors own work to ensure quality.
• Dependability - is consistently at work and on time, follows instructions, responds to management direction, and solicits feedback to improve performance.
• Technological proficiency - must be computer technology savvy and proficient in MS Office.

Required Education

High-school diploma in combination with relevant work experience

Experience

1-3 years' experience within a Physician-based Billing environment preferred

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