Insurance Follow Up Representative

TEKsystems • Dallas, TX

8d • $24 - $27 • Hybrid

About The Position

The Insurance Follow Up Representative submits claims, posts payments, handles payer rejections and denials, and follows up to help ensure accurate and timely claim processing and payment. The role follows applicable compliance and regulatory processes, payer guidelines, and internal policies and procedures. It is based in Dallas, Texas, and is a hybrid contract-to-hire position.

The representative bills claims to Medicare, Medicaid, and commercial insurers electronically or on paper, primarily using Niko Health claim submission software and Salesforce. The role includes working with payers to resolve claim-processing and payment issues, analyzing and posting EOB payments and denials, identifying root causes and ways to prevent future rejections or denials, and advising management and the appeals team when needed. The representative also routes uncollectible claims or balances to the appropriate review or write-off queues and responds to billing inquiries from patients, doctors, customers, and coworkers.

This position also contributes to process improvements and other duties or projects as needed. The stated pay range is $24.00–$27.00 per hour. Eligible benefits for the temporary role may include medical, dental and vision coverage; critical illness, accident, and hospital coverage; a 401(k) retirement plan; life insurance; short- and long-term disability; a health spending account; transportation benefits; an employee assistance program; and time off or leave.

Requirements

• Comprehensive understanding of Medicare, Medicaid, and/or commercial insurance program rules as they pertain to DME billing.
• Ability to take direction and communicate effectively with customers and employees at all levels of the organization.
• Ability to thrive in a fast-paced, dynamically changing organization.
• Strong work ethic.
• Excellent oral and written communication skills.
• Strong attention to detail.
• Ability to prioritize and manage daily responsibilities effectively.
• Solutions-oriented problem-solving ability.
• Excellent planning, communication, and organizational skills.
• A combination of training, education, and experience equivalent to the listed qualifications that provides the required knowledge, skills, and abilities.

Nice To Haves

• Two years of Medicare, Medicaid, and/or commercial insurance experience, particularly in HME, highly preferred.
• Intermediate knowledge or proficiency in Microsoft Office products and Salesforce, highly preferred.

Responsibilities

• Submit claims, post payments, handle payer rejections and denials, and complete follow-ups to support accurate and timely processing and payment.
• Follow applicable compliance and regulatory processes, payer guidelines, and internal policies and procedures.
• Bill claims to Medicare, Medicaid, and commercial insurers electronically or on paper using applicable policies and systems.
• Work with payers to ensure medical claims are processed timely and paid accurately.
• Analyze and post EOB payments and denials in billing systems, ensuring correct processing and payment.
• Identify root causes and prevention measures for future rejections and denials, advising management and the appeals team when necessary.
• Route claims or balances deemed uncollectible to Financial Patient Responsibility Review or Write Off Queues in a timely and appropriate manner.
• Respond to billing inquiries from patients, doctors, customers, and coworkers, providing the highest level of support possible.
• Identify process improvement opportunities and recommend solutions to improve departmental workflow.
• Assist with other duties or projects as needed.

Benefits

• Medical, dental, and vision coverage, if eligible.
• Critical illness, accident, and hospital coverage, if eligible.
• 401(k) retirement plan with pre-tax and Roth post-tax contributions available, if eligible.
• Voluntary life and AD&D insurance for employees and dependents, if eligible.
• Short- and long-term disability coverage, if eligible.
• Health Spending Account (HSA), if eligible.
• Transportation benefits, if eligible.
• Employee Assistance Program, if eligible.
• Time off or leave, including PTO, vacation, or sick leave, if eligible.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed