Insurance Follow-Up Specialist
Revco Solutions
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $19 - $22 per hour
About the role
- Conduct detailed analysis and follow-up on outstanding insurance claims (both commercial and government), ensuring timely and accurate resolution in accordance with payer guidelines.
- Research and resolve claim denials, rejections, and underpayments by initiating appropriate billing corrections, appeals, and resubmissions.
- Prepare and submit claim documentation—including EOBs, itemized statements, and medical records—as required by payers to support claim adjudication.
- Respond to payer and patient inquiries related to delinquent claims, maintaining compliance with privacy regulations and payer contract guidelines.
- Utilize payer portals, Electronic Health Records (EHR), and patient accounting systems to investigate claim status, post notes, and manage follow-up activities.
- Identify trends in denials and payment delays, contributing to process improvement initiatives and strategies for reducing AR days.
- Maintain accurate and detailed records of account activity, ensuring that production goals and quality standards are consistently met or exceeded.
- Demonstrate strong communication skills when interacting with insurance representatives, patients (as appropriate), and internal departments to resolve outstanding issues.
- Prioritize and organize daily workload effectively to meet departmental benchmarks in a fast-paced, high-volume environment.
- Provide support on special projects and additional assignments as requested by management
Requirements
- 2 years of previous experience working with commercial or other third-party insurance claims, medical billing/follow-up, BCBS experience is a plus
- An understanding of various forms, codes (CPT & ICD), insurance terminology and insurance company remittance advice
- EPIC experience preferred but not required
- Certificates, Licenses, Registrations, and/or Medicare certification are a plus, but not required
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical billingclaims analysisbilling correctionsappealsEOB preparationICD codingCPT codinginsurance terminologyclaim adjudicationprocess improvement
Soft Skills
communicationorganizationprioritizationproblem-solvingattention to detailtime managementinterpersonal skillsadaptabilityteam collaborationcustomer service
Certifications
Medicare certificationmedical billing certificationinsurance claims certificationCPT certificationICD certificationCertified Professional Coder (CPC)Certified Billing and Coding Specialist (CBCS)Certified Medical Reimbursement Specialist (CMRS)Certified Healthcare Financial Professional (CHFP)Certified Revenue Cycle Specialist (CRCS)