Medical Insurance Follow-Up Specialist

The role of a Medical Insurance Follow-Up Specialist is crucial in supporting healthcare providers by ensuring timely and accurate accounts receivable (A/R) processes. Medical Insurance Follow-Up Specialists play a key part in managing billing accounts, addressing denials, and resolving aged account issues for both hospital and physician billing. By maintaining a strong focus on denial resolution, account remediation, and insurance claims follow-up, these professionals contribute directly to the financial health of healthcare organizations.

Medical Insurance Follow-Up Specialists provide comprehensive support to revenue cycle operations, partnering closely with hospital organizations and healthcare providers to deliver high-quality accounts receivable solutions. Working full-time in a remote setting, specialists utilize their expertise to handle a variety of insurance-related challenges, from denial management to billing compliance and payer communication. This role is well suited to individuals who thrive in fast-paced environments and possess a strong problem-solving mindset, particularly those with prior experience in medical billing, insurance denials, and healthcare revenue cycle management.

As a Medical Insurance Follow-Up Specialist, you will interact with commercial and government payers, collaborate with internal teams, and communicate professionally with clients to secure payment and resolve outstanding claims. The ability to research complex account issues, review claim forms for accuracy, and identify payer trends is fundamental to success in this role. Specialists are expected to maintain productivity and quality standards while working independently and as part of a larger remote team.

In addition to technical expertise, proficiency with medical billing systems such as Epic, Cerner, Meditech, McKesson, Allscripts, Soarian, and similar platforms is highly valuable. Strong multitasking abilities, attention to detail, and advanced knowledge of Microsoft Office and internet-based systems are also essential. Educational qualifications typically include a high school diploma or equivalent, with an associate's or bachelor's degree being preferred. Prior experience in healthcare revenue cycle management and familiarity with UB-04 and HCFA 1500 claim forms are required.

This position offers the opportunity to work remotely, providing flexibility and the ability to join a growing organization focused on career advancement and professional development. If you are passionate about contributing to efficient revenue cycle operations, enjoy resolving complex account issues, and have a background in medical billing and insurance follow-up, consider applying for this rewarding role.

• Responsible for back-end accounts receivable follow-up and denial resolution for hospital and physician billing accounts.
• Delivers remote support to healthcare providers and hospital organizations to ensure efficient revenue cycle management.
• Focuses on claim follow-up, aged account remediation, and accurate billing compliance.
• Works full-time as part of a growing and dynamic remote team.

• Perform second-tier insurance account follow-up on outstanding A/R balances.
• Resolve denied, underpaid, and unresolved insurance claims in a timely manner.
• Address aged accounts, payer issues, and high-dollar accounts through detailed research.
• Review UB-04 and/or HCFA 1500 claims for billing accuracy and compliance.
• Investigate eligibility discrepancies, coding issues, payer denials, and reimbursement variances.
• Communicate professionally with insurance payers, clients, and internal teams to facilitate claim resolution.
• Identify payer trends, workflow issues, and barriers to resolution, sharing insights with team leadership.
• Submit corrected claims, rebills, secondary billing, and appeals as necessary.
• Document account activity and correspondence thoroughly and accurately in relevant systems.
• Escalate payer errors appropriately for reprocessing and resolution.
• Collaborate with both commercial and government payers to secure payment.
• Adhere to productivity and quality standards while working independently in a remote environment.

• Competitive hourly wage commensurate with experience.
• Comprehensive health, dental, vision, and life insurance packages.
• Paid time off (PTO), paid sick leave, and paid holidays.
• Remote work flexibility to support work-life balance.
• Opportunities for career growth…