Insurance Follow Up Rep

** Job Summary and Responsibilities*
* As an Insurance Follow Up Rep, you will resolve unpaid insurance claims and collect outstanding balances from third-party payers.

Every day you will review denials, initiate follow-up with insurers, rectify billing errors, submit appeals, and negotiate for maximum reimbursement.

To be successful, you will understand billing regulations, possess strong problem-solving skills, and communicate effectively to optimize revenue recovery.

+ Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers.

+ Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received.

+ Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements.

+ Resubmits claims with necessary information when requested through paper or electronic methods.

+ Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify.

+ Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels.

** Job Requirements*
* Required

+ High School Graduate or

+ High School GED

Preferred

+ Other Graduation from a post-high school program in medical billing or other business-related field and Two years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities.

** Where You'll Work*
* CHI Memorial Medical Group (Mountain Management Services), a member of Common Spirit Health, is a leading provider of comprehensive office management services for Memorial Health Partners and affiliated physicians in Southeast Tennessee and North Georgia. Our award-winning, faith-based organization is dedicated to supporting the delivery of exceptional healthcare in the region. We are proud to be consistently recognized for excellence by organizations like U.S. News & World Report, PINC AI, CMS, Health grades®, Leapfrog, and as one of the Best Places to Work in Tennessee.

We are honored to be your trusted ally in health, dedicated to serving our community with compassion and excellence.

** Pay Range*
* $16.42 - $23.19 /hour

We are an equal opportunity/affirmative action employer.