Insurance Follow Up Rep

CHI; Omaha (NE); On-site; USD 35,000 - 55,000; Full time

Job summary

An established industry player is seeking an Insurance Follow Up Representative to manage communications with health insurance payers. This role is vital in resolving balances and denials, ensuring accurate reimbursement processes. You will engage in various tasks, including phone calls and online processing, while maintaining high standards of confidentiality and professionalism. With a focus on detail and effective communication, you will contribute to the efficiency of the healthcare billing process. Join a team that values your well-being and offers comprehensive benefits to support your work/life balance.

Benefits

Health/Dental/Vision Insurance

Tuition Assistance

Paid Time Off (PTO)

Employee Assistance Program (EAP)

Matching 401(k) and 457(b) Retirement Programs

Wellness Programs

Flexible spending accounts

Adoption Assistance

Premium Access to Family Care Program

Direct Primary Plan

Qualifications

• Knowledge of healthcare policies and practices.
• Proficiency in interpreting insurance reimbursement terms.

Responsibilities

• Communicate with insurance payers to resolve outstanding balances.
• Document actions in the billing system thoroughly.
• Identify trends within the follow-up process.

Skills

Healthcare concepts knowledge

Medical insurance understanding

CPT and ICD code familiarity

Data entry skills

Customer service skills

Attention to detail

Effective communication

Critical thinking skills

Education

High School Diploma or equivalent

Post-high school training in medical billing

Tools

Automated billing systems

Office equipment proficiency

Job description

Overview

CHI Health strives to care for you the way you care for your patients.

We understand you have personal responsibilities outside of your profession and also care about your well-being.

With you in mind, we offer the following benefits to support your work/life balance:

• Health/Dental/Vision Insurance
• Direct Primary Plan (No copay, no deductible, and access to CHI Health provider 24/7)
• Premium Access to our Family Care Program supporting your needs for childcare, pet care, and/or adult dependent care
• Voluntary Protection: Group Accident, Critical Illness, and Identity Theft
• Employee Assistance Program (EAP) for you and your family
• Paid Time Off (PTO)
• Tuition Assistance for career growth and development
• Matching 401(k) and 457(b) Retirement Programs
• Adoption Assistance
• Wellness Programs
• Flexible spending accounts

From primary to specialty care as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can focus on what matters: being healthy. We offer over 20 specialties and 100 locations, some with extended hours.

Responsibilities

The Insurance Follow Up Representative is responsible for communicating with both commercial and government health insurance payers to resolve outstanding balances and non-coding denials, following established standards and guidelines. Activities include phone calls, online processing, fax, and written correspondence, using work queues for organization. The role involves reviewing remittance advices, researching denial reasons, and resolving issues through appeals.

• Follow-up with insurance payers to research and resolve unpaid accounts, making necessary corrections in the system to ensure proper reimbursement.
• Interpret and apply Explanation of Benefits (EOBs) and remittance advices to verify correct payments.
• Communicate effectively to explain outstanding balances, denials, or underpayments, supported by accurate reasoning based on EOBs and payer requirements.
• Resubmit claims with required information via paper or electronic methods as needed.
• Identify trends and issues within the follow-up process and provide staff training to address them.
• Escalate complex issues appropriately and timely.
• Organize accounts by denial type or payer for bulk addressing via phone, spreadsheet, or online portals.
• Document all actions thoroughly in the billing system.
• Perform other duties as assigned by leadership.

Qualifications

Required Minimum Knowledge, Skills, and Abilities

• Knowledge of healthcare concepts, policies, standards, and practices related to the role.
• Understanding of medical insurance, payer contracts, CPT and ICD codes.
• Familiarity with regulatory and reporting requirements.
• Proficiency with automated systems relevant to the function.
• Ability to interpret insurance reimbursement terms, contractual adjustments, and remittance advice.
• Accurate data entry skills, timely and productive work habits.
• Awareness of industry trends and regulatory changes.
• Ability to troubleshoot and adapt instructions to various situations.
• Maintain confidentiality and exercise discretion with sensitive information.
• Attention to detail and critical thinking skills.
• Effective prioritization and task management under pressure.
• Excellent customer service and professional communication skills.
• Proficiency in English for communication and understanding.
• Ability to establish effective working relationships.
• Competency with office equipment and automated systems.

Preferred Qualifications

• High School Diploma or equivalent preferred.
• Post-high school training in medical billing or related field preferred.
• Two years of revenue cycle or related experience preferred.