Insurance Follow-Up & Denials Specialist – Hybrid

ZoomCare; Tigard (OR); Hybrid; USD 32,000 - 40,000; Full time

Benefits offered by this job

Medical benefits

401K with employer match

Paid time off

Paid holidays

Sabbatical program

Parental leave

Job summary

ZoomCare is seeking an Insurance Follow Up Specialist to join our team in the Pacific Northwest expansion. The role focuses on processing and appealing insurance claims, resolving balances, and ensuring accurate reimbursement.

We require 2+ years in medical billing, strong CPT/HCPCS/ICD-10 knowledge, and proficiency with payer portals. The position offers a hybrid schedule with on-site support and some remote days.

Qualifications

• 2+ years of medical billing experience with focus on professional billing and accounts receivable follow-up.
• Strong CPT, HCPCS, and ICD-10 coding knowledge and their application in submission and reimbursement.
• Experience with electronic billing systems and payer portals to manage claim status, denials, and appeals.
• Familiarity with insurance reimbursement methodologies, claim adjudication processes, and payer-specific requirements.
• Excellent written and verbal communication, with the ability to collaborate across teams and with external contacts.

Responsibilities

• Represent our values: Awesome, Creative, Respectful, Team Players, Get it Done.
• Work unpaid and partially paid insurance claims to resolve balances and secure accurate reimbursement.
• Research claim status using insurance portals, phone outreach, and written correspondence.
• Analyze denied or underpaid claims to identify root causes, trends, and corrective actions.
• Submit timely and well-documented appeals for denied claims following payer policies.
• Resubmit corrected claims with updated coding or demographics to facilitate adjudication.
• Maintain records of all follow-up activities in the billing system.
• Collaborate with coding teams and provider offices to resolve discrepancies.
• Monitor aging accounts and prioritize claims based on timely filing limits.
• Identify systemic issues and elevate concerns with supporting documentation.
• Meet or exceed productivity and quality benchmarks while adhering to privacy standards.
• Other duties as assigned.

Skills

Medical billing

Accounts receivable

Analytical skills

Communication

Attention to detail

Education

High school diploma

Associate's degree in healthcare administration

Tools

Billing software

Payer portals

Electronic billing systems

Job description

ZoomCare is seeking an Insurance Follow Up Specialist to join our team in the Pacific Northwest expansion. The role focuses on processing and appealing insurance claims, resolving balances, and ensuring accurate reimbursement.

We require 2+ years in medical billing, strong CPT/HCPCS/ICD-10 knowledge, and proficiency with payer portals. The position offers a hybrid schedule with on-site support and some remote days.