Medical Insurance Follow-Up Specialist

Freddie Mac; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company is seeking a Full-Time Remote Medical Insurance Follow-Up Specialist to ensure the timely resolution of outstanding insurance claims, particularly with Blue Cross Blue Shield. In this role, you will be responsible for investigating unpaid claims, preparing documentation for payers, and collaborating with various departments to maximize reimbursement while adhering to industry standards.

Qualifications

• 2 years of experience in insurance claims and medical billing/follow-up.
• Understanding of CPT & ICD codes and insurance terminology.
• EPIC experience preferred.

Responsibilities

• Conduct analysis on outstanding insurance claims, ensuring accurate resolution.
• Research and resolve claim denials and underpayments.
• Maintain accurate records and meet departmental benchmarks.

Skills

Claims Analysis

Medical Billing

Communication

Job description

Job Type

Full-time

Description

APPLY TODAY!! Full-Time Remote Medical Insurance Follow-Up Specialist

Position Description:

The Medical Insurance Follow-Up Specialist is responsible for ensuring the timely and accurate resolution of outstanding insurance claims, with a primary focus on Blue Cross Blue Shield accounts. 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
• EPIC experience preferred but not required
• Certificates, Licenses, Registrations, and/or Medicare certification are a plus, but not required

Salary Description

$18-20/hr.