Senior Insurance Follow Up Representative - Remote in PST or MST

Lensa; Las Vegas (NV); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading company in the business services sector is seeking a Senior Insurance Follow Up Representative to handle outstanding claims and ensure timely payments. This remote position requires strong knowledge of insurance processes and coding, along with effective communication skills. Candidates should possess a high school diploma and at least 3 years of relevant experience, with flexibility in work hours.

Qualifications

• 3+ years experience in Insurance follow-up, EOB, COB, Remits, CMS 1500, and appeal processing.
• Ability to work flexible shifts within business hours.

Responsibilities

• Contact insurance carriers/patients regarding outstanding claims.
• Identify denial root causes and prepare documentation for appeals.
• Process appeals and correct claims as needed.

Skills

Knowledge of CPT & Diagnosis Coding

Medical Terminology

Basic Anatomy

Interpersonal and team skills

Effective communication

Education

High School Diploma/GED or equivalent

Job description

Senior Insurance Follow Up Representative - Remote in PST or MST

The Business Services department is seeking a Senior Insurance Follow Up Representative to join their team full-time. Candidates must demonstrate knowledge of CPT & Diagnosis Coding, Medical Terminology, and basic Anatomy. Working knowledge of EOB, COB, Remits, CMS 1500, and appeal writing and processing is required.

The Insurance Follow Up Representative serves patients, clinicians, and staff by obtaining payment on outstanding receivables timely, resolving issues causing payment delays, contacting payers, and using websites to determine claim status. Responsibilities include investigating and resolving denied claims, identifying trends, and working with payer contracts and guidelines to ensure accurate insurance payments.

This full-time position involves working Monday to Friday during flexible hours within 7:00 AM - 4:30 PM PST, with options for start and end times. Overtime may be required. Training hours will be aligned with your schedule, with some days starting at 8:00 AM.

Remote work is available for those in Pacific or Mountain Time Zones, with requirements for a dedicated work area, secure environment, and reliable high-speed internet.

Primary Responsibilities

• Contact insurance carriers/patients regarding outstanding claims
• Identify denial root causes and prepare documentation for appeals
• Process appeals and correct claims as needed
• Ensure accounts are correctly set up in systems
• Manage worklists, respond to denied claims, and minimize aged claims

Minimum Qualifications

• High School Diploma/GED or equivalent
• 3+ years experience in Insurance follow-up, EOB, COB, Remits, CMS 1500, and appeal processing
• Knowledge of CPT & Diagnosis Coding, Medical Terminology, Basic Anatomy
• Ability to work flexible shifts within business hours

Preferred Qualifications

• CPC Certification
• Multi-specialty clinic experience
• Epic experience

Telecommuting Requirements

• Reside in Pacific or Mountain Time Zone
• Secure work environment and reliable internet

Soft Skills

• Interpersonal and team skills
• Effective communication
• Ability to meet deadlines and collaborate