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.
• 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.

• High School GED General Studies and two years of revenue cycle or related work experience upon hire.
• High School Graduate General Studies and two years of revenue cycle or related work experience upon hire and.
• Graduation from a post-high school program in medical billing or other business related field is upon hire.

From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.