Insurance Denial & Follow-Up Specialist

Children's Nebraska; Omaha (NE); Vor Ort; USD 42.000 - 54.000; Vollzeit

Zusammenfassung

Children’s Nebraska is seeking an Insurance Follow-up Specialist to manage communications with commercial or government payers, resolving outstanding balances and denials in a structured follow-up workflow. The role uses EOBs and medical records to support appeals and ensure timely payments.

Responsibilities include researching denial reasons, resubmitting claims with appropriate documentation, and maintaining accurate patient account records in the system.

Qualifikationen

• Organized, self-motivated and able to work independently.
• Intermediate computer skills including spreadsheets and word processing.
• Knowledge of hospital or professional billing, collection and reimbursement practices.
• Knowledge of medical insurance, CPT and ICD codes; attention to detail.

Aufgaben

• Follow up on insurance or government claims to research and resolve unpaid claims and denials.
• Explain balances to payers or patients; resubmit claims with necessary documentation.
• Keep up to date with payor requirements through workshops and portals.
• Comply with HIPAA, EDI formats and billing regulations.

Kenntnisse

Organized

Spreadsheet

Communication

HIPAA knowledge

Medical billing

Ausbildung

High School Diploma

Associate's Degree in Business/Finance

Jobbeschreibung

Children’s Nebraska is seeking an Insurance Follow-up Specialist to manage communications with commercial or government payers, resolving outstanding balances and denials in a structured follow-up workflow. The role uses EOBs and medical records to support appeals and ensure timely payments.

Responsibilities include researching denial reasons, resubmitting claims with appropriate documentation, and maintaining accurate patient account records in the system.