Healthcare Billing Claims Follow Up Specialist

Remote Jobs At Sandstone Care; United States; Remote; Full time

Job summary

An established industry player in healthcare is seeking a Claims Follow Up Specialist to join their remote team. In this pivotal role, you will resolve complex insurance claims, ensuring maximum revenue recovery. You will work closely with insurance carriers to address unpaid accounts and manage the escalation process for complex claims. The ideal candidate will possess a strong background in medical billing, with proven negotiation skills and familiarity with CPT and ICD-10 coding. This is a fantastic opportunity to contribute to a supportive community dedicated to delivering exceptional care while enjoying a flexible work environment.

Benefits

Flexible PTO

Medical Insurance

Dental Insurance

Vision Insurance

Employee Assistance Program

Professional Growth Opportunities

Bonus Incentive Programs

Qualifications

• 3-5 years of experience in medical billing required.
• Proven ability in collections and negotiation preferred.

Responsibilities

• Follow up on unpaid or rejected insurance claims.
• Submit corrected claims and manage complex claim issues.

Skills

Medical Billing

Insurance Claims Resolution

Negotiation Skills

CPT Coding

ICD-10 Coding

Problem Solving

Communication Skills

Tools

PC Applications

Job description

Healthcare Billing Claims Follow Up Specialist

Sandstone Care - Remote

Position: Claims Follow Up Specialist

Job Type: Full Time

Location: Remote (CO / IL / MD / VA)

Schedule: Monday to Friday 8:30am to 5:00pm

Compensation: $24-28 Per Hour

About The Role

The Claims Follow Up Specialist is responsible for resolving complex insurance claims by providing daily problem resolution with insurance carriers. The goal is to recover the maximum revenue possible on each unpaid account. Reviews and provides technical direction or recommendations on claims of various complexity. Handles projects for complex claims and/or payers as assigned by the Claims Manager.

Key Responsibilities:

• Responsible for the follow-up on unpaid or rejected insurance claims for assigned carriers and will work with insurance companies, and/or staff to resolve account issues.
• Responsible for submitting corrected claims for the team.
• Responsible for the escalation appeal process for complex rejected claims, going above and beyond to support clients and families in need.
• Responsible for complex claim issues.
• Responsible for any escalation projects assigned by direct manager.

Experience Requirements:

• Must have a minimum of 3-5 years of hands-on experience in a fast-paced medical billing environment.
• Proven ability in collections and negotiation is highly preferred.
• Must have successful track record of adjudicating out of network claims and issues.
• Must have previous experience in a healthcare setting.
• Must have previous experience with CPT and ICD-10.
• Must have solid PC and application skills.
• The ability to handle a very high volume of work with speed and accuracy is essential.
• Must have the ability to understand and apply contract language to billing.
• Must have the ability to communicate in a professional manner internally and with payers.
• Must have experience in complex denials and appeal processes.

Other Requirements:

• Candidates applying for this position should be aware that an offer for employment in this position is contingent upon passing a comprehensive background check, encompassing criminal records and motor vehicle reports.

The Perks

At Sandstone Care, we believe that great care starts with our employees. That’s why we offer a comprehensive benefits package to support you in your personal and professional journey. Some of the benefits include:

• A competitive compensation and total rewards package including a meaningful hourly rate, bonus incentive programs, merit-based pay increases, and professional growth opportunities.
• A flexible PTO package that includes accrued PTO, paid holidays, and wellbeing days.
• High quality medical, dental, and vision insurance with a variety of package options that meet your needs and majority company paid.
• A robust Employee Assistance Program: Including counseling, legal consultations, financial planning, and wellness coaching.
• A collaborative and supportive community of team members: Fostering a positive work environment.

What to Expect: Our Interview Process

Here's an overview of what comes next:

• Application Review: We'll promptly review your application within one business day.
• Discovery Call: Expect a 30-minute discovery call with one of our Recruiters.
• Supervisor Interview: Expect a 1-hour video interview with our Sr. Claims Manager.
• Offer: If all goes well, you'll receive an offer.

Expected Interview Timeline: The entire process typically takes 1-2 weeks.

Sandstone Care’s Commitment to Diversity, Equity, & Inclusion

At Sandstone Care, we are committed to fostering a culture of diversity, equity, and inclusion that not only enriches the lives of our employees but also ensures the wellbeing and care of our clients, regardless of their race, ethnicity, gender identity, sexual orientation, socioeconomic status, age, ability, or background. We believe that embracing diversity and promoting equity and inclusion are integral to our mission of providing high-quality behavioral health services.

Sandstone Care is an equal opportunity employer and prohibits discrimination and harassment of any kind. We are committed to creating a diverse and inclusive workplace where all employees feel valued, respected, and empowered. We do not discriminate based on race, color, religion, creed, age, sex, national origin, ancestry, marital status, veteran status, sexual orientation, gender identity, disability, or any other legally protected status. All employment decisions are based on qualifications, merit, and business needs.

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