Medical Insurance Follow-Up Representative

The Medical Insurance Follow-Up Representative plays a pivotal role in the healthcare revenue cycle, ensuring that hospitals and physician billing accounts are managed efficiently and accurately. As a Medical Insurance Follow-Up Representative, you will be responsible for back-end accounts receivable (A/R) follow-up, denial resolution, and remediation of aged accounts. This position is ideally suited for those with strong analytical skills and a commitment to supporting healthcare providers in maximizing their revenue flow.

This full-time opportunity offers the flexibility of remote work, allowing you to deliver essential services from the comfort of your own environment while connecting with a team of professionals dedicated to excellence in medical billing and insurance claims resolution.

The Medical Insurance Follow-Up Representative is integral to the financial health of healthcare organizations. By working closely with both commercial and government payers, and utilizing your expertise with hospital and physician billing, you will help address and resolve denied, underpaid, or outstanding insurance claims. Your attention to detail and strong communication abilities will be key in researching account discrepancies, submitting appeals, and ensuring accurate documentation throughout the entire collections and reimbursement process.

This role is perfect for those who thrive in a fast-paced setting, enjoy problem-solving, and are looking to advance their career in the healthcare revenue cycle industry.

You will have the opportunity to work with industry-standard systems such as Epic, Cerner, Meditech, McKesson, Allscripts, and Soarian. Your proficiency in Microsoft Office and other relevant software will support you in multitasking across multiple platforms, ensuring efficient workflow and effective issue resolution. If you are passionate about healthcare finance, have experience in revenue cycle management, and are eager to make a meaningful impact, this is the ideal role to grow your career.

This position is responsible for performing second-tier insurance account follow-up, resolving denied and unpaid claims, and addressing reimbursement variances for hospital and physician billing accounts. The Medical Insurance Follow-Up Representative works collaboratively with healthcare clients, insurance payers, and internal teams to ensure claims are processed accurately and efficiently. This role supports the overall mission of enhancing revenue cycle operations and sustaining the financial viability of healthcare providers.

• Conduct comprehensive follow-up on outstanding accounts receivable balances for hospital and physician billing accounts.
• Resolve insurance denials, underpayments, and unresolved claims by investigating eligibility, coding, and payer inconsistencies.
• Research and remediate aged accounts and payer issues, including high-dollar and complex claims.
• Review UB-04 and HCFA 1500 claims forms for billing accuracy and compliance.
• Communicate professionally and effectively with insurance payers, clients, and internal teams to facilitate claim resolution.
• Identify trends and workflow issues that may hinder timely reimbursement and elevate concerns as needed.
• Submit corrected claims, rebills, secondary billing, and appeals to resolve claim discrepancies.
• Document all account activities, correspondence, and actions taken in a thorough and accurate manner.
• Work with both commercial and government insurance payers to maximize collection efforts.
• Maintain required productivity and quality standards as defined by company policies and industry best practices.

• Competitive hourly compensation reflecting experience and industry standards.
• Comprehensive benefits package including health, dental, vision, and life insurance options.
• Paid time off (PTO), paid sick leave, and paid holidays to support work-life balance.
• Opportunities for career growth and advancement within the healthcare revenue cycle field.
• Remote work flexibility, enabling you to perform your duties from anywhere with a stable internet connection.

• Minimum 1-2 years of experience in healthcare revenue cycle management, medical billing, or related field.
• Proven experience with hospital billing and/or physician billing processes.
• Strong knowledge of insurance denials management, A/R follow-up, and claims forms (UB-04, HCFA 1500).
• Proficiency in using medical…