Insurance Follow-Up Specialist

Vance Thompson Vision; Sioux Falls (SD); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical Insurance

PTO & Retirement

Shoe allowance

Education Allowance

Wellness Program & Lifestyle

Job summary

Vance Thompson Vision is seeking an Insurance Follow-Up Specialist to join our business office team. You will manage outstanding insurance claims, including rejections, and file secondary claims as needed.

You will also submit appeals on denials and process credits or refunds when necessary. Ideal candidates have an associate degree in Health Information Management and at least two years of medical insurance experience, with knowledge of billing regulations and terminology.

Qualifications

• Associate degree in Health Information Management or related field.
• At least two years’ experience in medical insurance or equivalent.
• Knowledge of medical insurance billing regulations and terminology preferred.

Responsibilities

• Process outstanding insurance claims, including rejected or failed claims from the clearinghouse.
• File claims to secondary insurance when needed.
• Submit appeals for denials or low reimbursements.
• Process insurance credits and request refunds for overpayments.
• Resolve denials through research, corrected claims, and adjustments.
• Review denials related to eligibility, COB, medical records, and simple billing errors.
• Identify and resolve no-response claims (unbilled, not received, invalid address).
• Answer daily calls and emails for the business office.

Skills

Detail-oriented

Multitasking

Adaptable

Prioritization

Education

Associate degree in Health Information Management

Job description

Why VTV

At Vance Thompson Vision, we take pride in being global leaders in vision correction, driven by our commitment to groundbreaking research, innovative technology, and exceptional patient care. With a reputation for setting the standard of excellence in our field, we continue to transform lives through better vision. We believe that exceptional care begins with an exceptional team. Be part of something greater—join us and discover what it means to create a world-class culture while making a meaningful impact.

Our Core Values That Provide Our Foundation

• Caring - We are passionate, empathetic, and sensitive to the needs of our teammates, patients, and everyone we touch.
• Fun - We choose a positive attitude every day. We use humor as a way to create a less formal, less stressful and more productive work environment.
• Committed - We are accountable and 100% committed to the Success of VTV. We are boundaryless; we are willing to take initiative to delight our customers, motivate fellow teammates and improve financial results.
• Egalitarian - We play on a team where everyone is equal, where no task is too small for any member to step up and own inside and outside their functional area.
• Excellence - We are committed to doing the extra work to be outstanding in customer service, patient care and team happiness.

Job Opportunity

We are growing and we are looking for an Insurance Follow-Up Specialist to join our team!

You Are

• Ready to live out our core values in patient and team member interactions
• Detail-oriented
• Able to multitask and prioritize
• Flexible and adaptable to change

You Will Make An Impact By

• Working outstanding insurance claims, as well as rejected or failed claims from the clearinghouse.
• Filing claims to secondary insurance as needed.
• Submitting appeals to insurance for denials or claims paid at low reimbursement.
• Processing insurance credits and requesting refunds for insurance overpayments.
• Resolving denials through research, corrected claims, and adjustments.
• Reviewing denials that are due to ineligibility, coordination of benefits, medical record requests, duplicate denials, simple billing errors and simple medical necessity errors.
• Identifying and resolving no response claims, such as unbilled claims, claims not received, and claims with an invalid billing address or billing methodology.
• Answering daily incoming patient/internal phone calls and emails coming to the business office department.

You Have

• A preferred associate degree in Health Information Management or a related field
• At least two years’ experience in medical insurance or equivalent work
• Preferred knowledge in medical insurance billing regulations and/or medical terminology

Investments In YOU

Vance Thompson Vision offers a full benefits package and competitive compensation, including:

• Medical, dental and vision insurance
• Employer paid benefits: paid time off, retirement savings contributions, life insurance and disability insurance
• A variety of voluntary benefits for you and your family
• Shoe allowance for full-time team members
• Education Allowance
• Wellness Program paired with a Lifestyle Spending Account

Vance Thompson Vision is an equal opportunity and affirmative action employer. We are committed to creating a diverse and inclusive culture for all employees.