Insurance Follow-Up Specialist

Revco Solutions; United States; À distance; USD 55 000 - 75 000; Plein temps

Résumé du poste

Revco Solutions is seeking a remote Insurance Follow-Up Specialist to ensure timely resolution of outstanding insurance claims. You will investigate unpaid or underpaid claims by communicating with carriers, identifying billing issues, and initiating corrective actions to maximize reimbursement.

Responsibilities include analyzing claim statuses, researching denials, and preparing documentation for payers. Experience with EHR systems and payer portals is expected in a fast-paced environment.

Qualifications

• 2 years of experience with commercial or other third-party insurance claims or medical billing/follow-up.
• Knowledge of CPT & ICD codes and insurance terminology.
• Medicare certification or related certificates are a plus, but not required.

Responsabilités

• Conduct analysis and follow-up on outstanding insurance claims (commercial and government).
• Research and resolve denials, rejections, and underpayments with corrections and appeals.
• Prepare and submit documentation including EOBs, itemized statements, and medical records as needed.

Formation

Certificates in medical billing (not required)

Outils

Meditech

EHR

Payer portals

Description du poste

All Jobs > Insurance Follow-Up Specialist

Full-Time Remote Insurance Follow-Up Specialist

Position Description:

The Insurance Follow-Up Specialist is responsible for ensuring the timely and accurate resolution of outstanding insurance claims. This role involves investigating and resolving unpaid or underpaid claims by communicating with insurance carriers, identifying billing issues, and initiating corrective actions. The specialist plays a critical role in maximizing reimbursement and supporting the overall revenue cycle by maintaining detailed documentation and adhering to regulatory and payer-specific guidelines.

Duties & Responsibilities:

• Conduct detailed analysis and follow-up on outstanding insurance claims (both commercial and government), ensuring timely and accurate resolution in accordance with payer guidelines.
• Research and resolve claim denials, rejections, and underpayments by initiating appropriate billing corrections, appeals, and resubmissions.
• Prepare and submit claim documentation—including EOBs, itemized statements, and medical records—as required by payers to support claim adjudication.
• Respond to payer and patient inquiries related to delinquent claims, maintaining compliance with privacy regulations and payer contract guidelines.
• Utilize payer portals, Electronic Health Records (EHR), and patient accounting systems to investigate claim status, post notes, and manage follow-up activities.
• Identify trends in denials and payment delays, contributing to process improvement initiatives and strategies for reducing AR days.
• Maintain accurate and detailed records of account activity, ensuring that production goals and quality standards are consistently met or exceeded.
• Demonstrate strong communication skills when interacting with insurance representatives, patients (as appropriate), and internal departments to resolve outstanding issues.
• Prioritize and organize daily workload effectively to meet departmental benchmarks in a fast-paced, high-volume environment.
• Provide support on special projects and additional assignments as requested by management

Requirements

• 2 years of previous experience working with commercial or other third-party insurance claims, medical billing/follow-up, BCBS experience is a plus
• An understanding of various forms, codes (CPT & ICD), insurance terminology and insurance company remittance advice
• Meditech experience preferred but not required
• Certificates, Licenses, Registrations, and/or Medicare certification are a plus, but not required