ZoomCare

Billing Specialist

• Represent our values: Awesome, Creative, Respectful, Team Players, Get it Done.
• Work unpaid and partially paid insurance claims to resolve outstanding balances and secure accurate reimbursement in accordance with payer guidelines.
• Research claim status by utilizing insurance portals, conducting phone outreach, and drafting written correspondence as needed.
• Analyze denied or underpaid claims to identify root causes, trends, and necessary corrective actions.
• Submit timely and well-documented appeals for denied claims in alignment with specific payer policies and appeal procedures.
• Resubmit corrected claims with updated coding, documentation, or demographic information to facilitate proper adjudication.
• Maintain thorough and accurate records of all claim follow-up activities within the billing or revenue cycle management system.
• Collaborate with coding teams, clinical documentation specialists, and provider offices to gather missing information or resolve claim discrepancies.
• Monitor aging accounts and prioritize claims based on timely filing limits and payer response windows.
• Identify systemic issues or process inefficiencies impacting claim resolution and escalate concerns to management with supporting documentation.
• Meet or exceed established productivity and quality benchmarks while adhering to compliance and privacy standards.
• Other duties as assigned.

Billing Specialist – Insurance Follow-up