Job Summary
We are seeking a proactive and detail-oriented Insurance Follow-Up Specialist to join our dynamic healthcare team. In this vital role, you will be responsible for managing outstanding insurance claims, ensuring timely follow-up with payers, and optimizing revenue cycle processes. Your expertise in medical coding, billing, and insurance procedures will help improve cash flow and reduce claim denials. If you thrive in a fast-paced environment and are passionate about healthcare administration, this is an exciting opportunity to make a meaningful impact on patient care and organizational efficiency.

Responsibilities

• Conduct thorough follow-up on unpaid or delayed insurance claims across various payers to secure payment.
• Review medical records, billing information, and coding details to identify discrepancies or issues affecting claim processing.
• Utilize EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems to track claim status updates and document follow-up activities accurately.
• Collaborate with medical offices, providers, and insurance companies to resolve claim denials, rejections, or requests for additional information.
• Apply knowledge of DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology) coding, ICD-9, ICD-10 codes, and medical terminology to ensure accurate claim submission and follow-up.
• Maintain detailed records of all communications, actions taken, and outcomes related to each insurance account.
• Stay updated on changes in insurance policies, billing regulations, and coding standards to ensure compliance and maximize reimbursement.

Requirements

• Proven experience in medical billing, medical coding, or healthcare administrative roles with a focus on insurance follow-up.
• Strong understanding of DRG, CPT coding, ICD-9/ICD-10 coding systems, and medical terminology.
• Familiarity with EMR/EHR systems used for managing medical records and billing information.
• Excellent communication skills to liaise effectively with insurance companies and healthcare providers.
• Ability to analyze medical records and billing data critically to identify issues impacting reimbursement.
• Prior experience working in a medical office environment is preferred but not required.
• Knowledge of medical collection processes and strategies for resolving unpaid claims is highly desirable. Join us as an Insurance Follow-Up Specialist and become a key player in ensuring our organization’s financial health while supporting excellent patient care! We are committed to fostering a collaborative environment where your skills can thrive and grow within the healthcare industry.

Pay: $47,020.30 - $56,626.61 per year

Work Location: Remote