Insurance Follow Up Rep

CHI Health Clinic; United States; On-site; USD 42,000 - 60,000; Full time

Job summary

CHI Health Clinic is seeking an Insurance Follow Up Representative to resolve unpaid claims and collect balances from third-party payers. You will review denials, initiate follow-up with insurers, correct billing errors, submit appeals, and negotiate for maximum reimbursement.

You should understand billing regulations, possess strong problem-solving skills, and communicate effectively to optimize revenue recovery across a network of clinics.

Qualifications

• Two years of revenue cycle or related work experience.
• Experience with a practice management system and billing workflows.
• Familiarity with Explanation of Benefits (EOBs) and payer requirements.

Responsibilities

• Follows-up with insurance payers to research and resolve unpaid accounts receivable.
• Reviews EOBs and remittance advices to ensure correct payment.
• Communicates with payers by phone and in writing to explain balances and denials.
• Resubmits claims with required information when requested.
• Identifies trends in denials and escalates issues per protocol.

Skills

Insurance follow-up

Revenue cycle

EOB interpretation

Education

High School Diploma or GED

Medical billing program certificate

Post-secondary business program

Job description

Where You'll Work

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 spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.

Job Summary and Responsibilities

As an Insurance Follow Up Rep, you will resolve unpaid insurance claims and collect outstanding balances from third-party payers.Every day you will review denials, initiate follow-up with insurers, rectify billing errors, submit appeals, and negotiate for maximum reimbursement.To be successful, you will understand billing regulations, possess strong problem-solving skills, and communicate effective to optimize revenue recovery.

• Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is receive.
• Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received.
• Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements.
• Resubmits claims with necessary information when requested through paper or electronic methods.
• Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify.
• Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels.

Job Requirements

Preferred

• High School GED General Studies and Two years of revenue cycle or related work experience , upon hire or
• High School Graduate General Studies and Two years of revenue cycle or related work experience , upon hire and
• Graduation from a post-high school program in medical billing or other business related field is , upon hire