Insurance Follow-Up Specialist (Remote) - Eastern Time, Central Time & Mountain Time

Med A/Rx•Sartell, MN

6d•$18 - $21•Remote

About The Position

The Insurance Follow-Up Specialist is responsible for hospital and physician billing follow-up activities focused on resolving unpaid, underpaid, denied, or rejected insurance claims. This role works directly with Medicare, Medicaid, private payers, and commercial insurance carriers to investigate claim issues, facilitate prompt payment, and reduce outstanding accounts receivable. Success in this role requires strong knowledge of patient billing, claims submission, payer-specific requirements, denial management, reimbursement practices, and insurance follow-up processes. The Insurance Follow-Up Specialist partners with insurance carriers, patients, clients, and internal revenue cycle teams to resolve claim challenges and maximize reimbursement for our healthcare partners.

Requirements

High School Diploma or GED
2+ years of insurance follow-up, denials management, medical billing, or healthcare collections experience
Experience working with Medicare, Medicaid, and commercial payers
Knowledge of patient billing, claims submission, and denial resolution processes
Proficiency with Microsoft Office (Outlook, Word, and Excel)
A secure and private workspace within their home
A reliable wired (preferred) high-speed internet connection
Minimum internet speeds of 30 Mbps download and 10 Mbps upload
The ability to maintain a professional and distraction-free work environment during scheduled working hours
Candidates must be legally authorized to work in the United States at the time of hire
The company does not provide employment visa sponsorship for this position

Nice To Haves

Experience in a hospital, physician practice, or healthcare revenue cycle environment
Experience with Epic, Cerner, Meditech, or other healthcare information systems
Knowledge of medical terminology, CPT, HCPCS, or ICD-10 coding
Previous remote healthcare revenue cycle experience

Responsibilities

Research and resolve denied, unpaid, underpaid, or incorrectly processed insurance claims.
Investigate claim rejections and denials by contacting insurance carriers and reviewing payer requirements.
Follow up with Medicare, Medicaid, Blue Cross, and commercial insurance carriers to obtain claim status updates and payment resolution.
Analyze denial codes, remittance advice, payer correspondence, and claim documentation to identify root causes and determine appropriate next steps.
Correct claim errors and facilitate claim resubmission to support timely reimbursement.
Prepare and submit appeals, reconsiderations, corrected claims, and supporting documentation as needed.
Manage assigned claim inventory and prioritize accounts to reduce aging accounts receivable.
Contact patients when necessary to obtain or verify information needed to resolve billing or insurance issues.
Review and update patient demographics, insurance information, and account details when necessary to facilitate claim resolution.
Document all account activity, payer communications, and claim resolutions accurately and timely.
Communicate professionally with insurance companies, patients, and client representatives regarding outstanding claims and balances.
Identify denial trends and recurring issues and communicate findings to leadership and operational teams.
Meet established productivity, quality, and cash collection performance standards.
Maintain compliance with HIPAA regulations, client requirements, and company policies.
Collaborate with Billing, Claims, Collections, and Client Services teams to resolve complex reimbursement issues.