Insurance Follow Up Specialist

About Us

We are committed to helping clients surpass their financial health objectives. Our comprehensive approach combines scalable reimbursement cycle solutions with clinical expertise to address programmatic needs. We empower our teams with advanced technology and data analytics to deliver effective solutions and ensure accountability in meeting goals.

We prioritize building lasting careers by investing in personal and professional growth, recognizing that your achievements are integral to our collective success.

Job Summary

The Insurance Follow Up Specialist plays a critical role in identifying and resolving insurance claim denials and processing errors to ensure account accuracy.

Key Responsibilities

• Manage unpaid or denied claims by utilizing proprietary software, conducting phone outreach, drafting correspondence, and accessing client systems and insurance portals to facilitate claim settlement.
• Examine medical documentation including UB04 claim forms, Explanation of Benefits (EOBs), and medical records to determine effective resolution strategies.
• Stay updated on client-specific preferences and common issues.
• Achieve established monthly production and quality targets.
• Adhere strictly to HIPAA privacy regulations.
• Perform additional duties as assigned.

Qualifications and Requirements

• High School Diploma or equivalent educational credential.
• Preferred: Minimum of one year experience in physician or hospital accounts receivable management.
• Familiarity with UB04 claim forms, EOBs, and medical records is advantageous.
• Experience with Epic, Cerner, Meditech, or other Electronic Medical Records (EMR) systems preferred.
• Proficient with basic computer operations.
• Capability to work productively in a remote setting.
• Strong oral and written communication abilities.
• Basic math skills including addition, subtraction, and percentage calculations.
• Analytical skills to interpret documents, contracts, notes, and correspondence.
• Effective multitasking skills in fast-paced environments.
• Highly organized with exceptional attention to detail.

Physical Requirements

Reasonable accommodations will be made for disabilities. The role requires regular coordination and manual dexterity to operate office equipment, extended periods of computer work (6-8 hours daily), and handling occasional interruptions. Prolonged sitting is common, with rare instances of lifting materials up to 20 pounds. Periods of increased workload and multiple deadlines may lead to elevated stress levels.

Additional Information

This job description outlines general duties but is not exhaustive. Responsibilities and requirements may be updated by supervisors as needed.