SHS-BILLING FOLLOW-UP SPECIALIST

Sparrow•East Lansing, MI

33d

About The Position

A Billing Follow-Up Specialist is responsible for accurate and timely follow-up on assigned denied or unpaid accounts, ensuring prompt and accurate reimbursement for services rendered by appealing denials, correcting claims, and working with payers to resolve outstanding balances. The role maintains daily work queues according to prioritization guidelines, meets quality and productivity standards, and documents follow-up activity in Epic in accordance with department policies. The specialist also validates account payments and adjustments, identifies recurring denial trends or payer issues for escalation, and participates in team discussions and other department activities. Additional duties may include maintaining knowledge of department processes and procedures, pursuing self-directed learning and continuing education, and participating in committees, task forces, and work groups as determined by management.

Requirements

1–2 years of experience in healthcare collections, claims follow-up, or denial management.
High school diploma or GED.
Ability to work independently with minimal supervision.
Detail-oriented, with strong problem-solving and communication skills.
Proficiency with computer functions, including automated systems for third-party billing and insurance follow-up.
Professional, business-like appearance and demeanor.
Ability to recognize and report problems, errors, and discrepancies to management.
Ability to share information with coworkers and contribute to team efforts.
Ability to assist with training new employees as needed.
Knowledge of payer guidelines, including use of payer websites and other tools.

Nice To Haves

EPIC or Revenue Cycle Certification preferred.

Responsibilities

Follow up on unpaid or denied claims to ensure timely and accurate reimbursement.
Analyze denial reasons and take appropriate action to appeal or resubmit claims.
Contact payers and use online portals to resolve outstanding account balances.
Collaborate with billing, coding, and clinical staff to gather documentation for appeals or claim corrections.
Track and document follow-up activities in Epic in compliance with department policies.
Identify and solve problems, escalating recurring denial trends or payer issues to team leaders when necessary.
Validate that payments and adjustments made on accounts are correct.
Maintain daily work queues according to work queue prioritization guidelines.
Maintain quality and productivity standards and participate in team meetings to discuss recurring issues.
Maintain current knowledge of department processes, protocols, and procedures; pursue self-directed learning and continuing education; and participate in committees, task forces, and work groups as determined by management.
Perform other duties as assigned.