Insurance Follow-Up Specialist

VANCE THOMPSON VISION CLINIC PROF L•Sioux Falls, SD

2d•Onsite

About The Position

Vance Thompson Vision is seeking an Insurance Follow-Up Specialist to support its business office department. The role focuses on insurance claims follow-up, denial resolution, appeals, credits and refunds, and responding to patient and internal inquiries. The organization describes itself as a leader in vision correction, with a commitment to research, innovative technology, exceptional patient care, and a collaborative culture grounded in its values of Caring, Fun, Committed, Egalitarian, and Excellence.

Requirements

At least two years of experience in medical insurance or equivalent work.
Detail-oriented.
Able to multitask and prioritize.
Flexible and adaptable to change.
Ready to demonstrate the organization's core values in interactions with patients and team members.

Nice To Haves

Associate degree in Health Information Management or a related field.
Knowledge of medical insurance billing regulations and/or medical terminology.

Responsibilities

Work outstanding insurance claims and rejected or failed claims from the clearinghouse.
File claims to secondary insurance as needed.
Submit appeals for denied claims or claims paid at low reimbursement.
Process insurance credits and request refunds for insurance overpayments.
Research and resolve denials through corrected claims and adjustments.
Review denials related to ineligibility, coordination of benefits, medical record requests, duplicate denials, simple billing errors, and simple medical necessity errors.
Identify and resolve no-response claims, including unbilled claims, claims not received, and claims with an invalid billing address or billing methodology.
Answer daily incoming patient and internal phone calls and emails directed to the business office department.