Hospital Insurance Follow-up Representative HB & PB (opens in new tab)

Internationalinsuranceprofessionals; Wheat Ridge (CO); A distancia; USD 52.000 - 75.000; Jornada completa

Descripción de la vacante

Internationalinsuranceprofessionals is seeking experienced insurance follow-up representatives to work remotely in the United States, focusing on hospital and professional billing in Epic with automation support.

You will manage AR for hospital and professional claims, resolve denials, use payer portals, and maintain clear documentation to ensure seamless handoffs and accurate billing trends reporting.

Formación

• 2+ years of insurance follow-up or AR experience in Epic Resolute HB and PB.
• Working knowledge of UB-04 and CMS-1500 claims, revenue codes, CPT/HCPCS, and ICD-10.
• Experience with commercial, Medicare, Medicaid, and managed care payers.
• Able to read and act on EOBs, remittances, and CARC/RARC denial codes.
• Comfortable working independently and meeting productivity and quality goals.

Responsabilidades

• Follow insurance AR for hospital (UB-04) and professional (CMS-1500) claims.
• Work Epic Resolute HB and PB queues to resolve unpaid, underpaid, and denied claims.
• Check claim status through payer portals and phone calls.
• Research denials, correct and resubmit claims, and file appeals.
• Document accounts clearly so the next person knows current state.
• Escalate payer trends and recurring denial issues.

Conocimientos

Insurance follow-up

Epic Resolute HB

Epic Resolute PB

AR experience

UB-04 & CMS-1500 knowledge

Herramientas

Availity

Descripción del empleo

About the Role:

Healthcare Outsourcing Network is a revenue cycle partner to hospitals and health systems. We handle self-pay, customer service, and back-office work, and we use modern automation (API integrations, RPA, and AI tools) so our reps spend their time on accounts that need real expertise. We're hiring experienced insurance follow-up reps to work remotely who know both hospital and professional billing in Epic.

What You'll Do:

• Work insurance AR follow-up for hospital (UB-04) and professional (CMS-1500) claims
• Work Epic Resolute HB and PB work queues to resolve unpaid, underpaid, and denied claims
• Check claim status through payer portals and phone calls
• Research denials, correct and resubmit claims, and file appeals
• Document accounts clearly so the next person knows exactly where things stand
• Escalate payer trends and recurring denial issues

Required:

• 2+ years of insurance follow-up or AR experience in Epic Resolute HB and PB
• Working knowledge of UB-04 and CMS-1500 claims, revenue codes, CPT/HCPCS, and ICD-10
• Experience with commercial, Medicare, Medicaid, and managed care payers
• Able to read and act on EOBs, remittances, and CARC/RARC denial codes
• Comfortable working independently and meeting productivity and quality goals

Nice to Have:

• Appeals writing experience
• Experience with secondary claims and coordination of benefits
• Familiarity with payer portals like Availity
• Experience working for an RCM vendor or a large health system