We are seeking a proactive and detail-oriented Insurance Follow-Up Specialist to manage outstanding insurance claims and ensure timely reimbursement. The ideal candidate will be experienced in navigating payer guidelines, resolving claim delays, and communicating effectively with insurance representatives. This role is critical for maintaining strong cash flow and reducing accounts receivable aging within the organization.

Key Responsibilities

• Review and manage aging insurance accounts to ensure timely follow-up and resolution of unpaid or underpaid claims.

• Contact insurance companies via phone, portal, or written communication to obtain claim status, appeal decisions, or correct issues preventing payment.

• Identify and correct errors related to coding, billing, coverage, or documentation that contributed to claim denials or delays.

• Prepare and submit appeals, reconsiderations, and corrected claims as needed.

• Document all follow-up activities clearly and accurately in the billing system.

• Collaborate with medical billers, coders, and providers to gather missing information or clarify discrepancies.

• Analyze denial trends and provide feedback to leadership to improve billing processes.

• Maintain knowledge of payer policies, federal regulations, and industry changes affecting reimbursement.

• Protect patient privacy and adhere to HIPAA compliance requirements at all times.

Qualifications

• Preferred:

  • Experience in medical billing, insurance follow-up, or healthcare revenue cycle operations.

  • Knowledge of CPT, ICD-10, HCPCS, and common denial codes.

  • Familiarity with major government and commercial payers.

  • Experience working with practice management systems, clearinghouses, and insurance portals.

• Additional Skills:

  • Strong communication and negotiation skills.

  • High attention to detail and accuracy.

  • Ability to work independently and manage multiple accounts efficiently.

  • Analytical mindset to identify root causes of claim issues.