Insurance Follow-up Specialist

ECU Health Medical Center • Greenville, NC

3d

About The Position

The Insurance Follow-up Specialist submits and manages third-party payer claims, including primary, secondary, tertiary, and corrected claims. The role reconciles electronic submission confirmation reports, corrects and revalidates claims, and responds to payer rejections and denials. The specialist also follows up with payers to collect payments, verifies payment accuracy, pursues underpayments, negotiates reimbursement rates with non-contracted payers and case managers, keeps current on relevant billing and reimbursement rules, processes correspondence, and demonstrates service excellence.

Responsibilities

• Submit primary, secondary, tertiary, and corrected claims to third-party payers using electronic billing software.
• Reconcile electronic submission confirmation reports from third-party payers; process needed corrections and electronically revalidate claims.
• Analyze payer rejections and denials and take appropriate action.
• Perform follow-up and collections with third-party payers.
• Verify payment accuracy using managed care payer software and pursue underpayments.
• Negotiate reimbursement rates with non-contracted third-party payers and case managers.
• Stay current on rules and regulations affecting billing, reimbursement, and claims submission.
• Process correspondence from third-party payers and patients.
• Perform other related responsibilities as required or requested.
• Demonstrate service excellence.

What This Job Offers

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