Insurance Follow-up Specialist

JOB SUMMARY:

The Insurance Follow-up Representative position is responsible for all insurance follow-up on assigned accounts from the management team. The core responsibilities of an insurance follow-up representative include research, insurance billing and adjustment identification to ensure proper account resolution.

• Obtain Claim Status via the Telephone, Internet and/or Fax
• Review and Interpret Contractual Terms for Managed Care, Commercial, Medicare, Medicaid and Workers’ Compensation
• Obtain Supporting Documentation Regarding Insurance Follow-up Efforts
• Identify Contractual and Administrative Adjustments Billing via Electronic and Hard copy Submission

Education: High school diploma or equivalent. A minimum of two years previous work experience as an insurance follow-up representative or Accounting is required. Must have full understanding of insurance follow-up processes (i.e., Billing, Collections, Managed Care, Medicare, Medicaid, and Commercial Practices), and well-developed interpersonal skills.

• Excellent verbal and written communication skills
• Reliable attendance record
• Knowledge of EOBs, CPT & ICD-9 codes, HCFAs, UB92s, HCPCS, DRGs and authorizations/referrals
• Good problem-solving skills
• Ability to learn / stay abreast of relevant policies
• Ability to type a minimum of 40 wpm
• Detail oriented and well organized
• Ability to perform under pressure in a calm manner
• Basic math skills
• High degree of accuracy
• Positive attitude

The work is mainly sedentary, but may require walking, bending, standing, and/or carrying of light items such as files, manuals, and medical records.