Remote Health Insurance Follow-up Specialist

Our rapidly growing client is hiring several Remote Insurance Follow-up Representatives. These positions are responsible for reviewing data to ensure the validity of insurance information for claims processing. You will also answer inquiries involving individual accounts and research problems to ensure accuracy for payment. If you are enthusiastic, sharp, and committed we would love for you to join our team. Must be able to work remotely Monday-Friday 8am-5pm.

Responsibilities:

• Follow-Up with Insurance Carriers to determine reason for claims denial and work to resolve claim for payment.
• Process claims, payments, adjustments, refunds, denials and unpaid insurance balances
• Assess and correct, when needed, demographic, insurance and financial information
• Provide accurate account maintenance and documentation
• Uses and demonstrates understanding of the applicable computer systems, including system reports and security procedures
• Serve as a liaison with insurance companies, third party payors, and administrative personnel
• Analyze EOB’s and account documentation to identify, reconcile and resolve patterns resulting in erroneous or no reimbursement
• Review payer contracts and ensure accounts are resolved consistent with terms
• Ability to resolve insurance denials and file appeals with government and commercial carriers
• Accurately and efficiently processes the account including transaction recording and other functions.
• Stays up to date on contracts, regulations, procedures and other changes affecting the department.
• Reports unusual accounts, account problems and workflow issues promptly to manager.
• Demonstrates positive and professional communication skills.
• Performs other work duties as assigned

Qualifications:

• High School Diploma required
• 3-5 years of insurance follow-up experience in a hospital or physician’s office setting is preferred
• Thorough understanding of CPT, DRG, HCPC, Procedure and Revenue codes, modifiers and their effect on reimbursement
• Experience with filing UB-04 and HCFA 1500 claim form required
• Background check and reference checks required

Compensation:

• $16.00 – $20.00/hr
• Health Insurance
• 401k