Claims Follow-Up Representative

Job Summary

To ensure timely reimbursement for a large multi-specialty, multi-state physician practice, the full-time Claims Follow-Up Representative will manage outstanding claims and correct denied claims under the supervision of the PFS Supervisor of Claims Follow-up and Denials, with the option for remote, hybrid, or in-office work arrangements.

Key responsibilities:

• Review and correct denied claims, sending appeals to third-party payers to secure reimbursement
• Resolve outstanding, underpaid, and overpaid claims while identifying denial trends and reporting to the supervisor
• Maintain compliance with HIPAA guidelines and collaborate with internal departments to gather necessary claim information

Required qualifications:

• High school graduate or equivalent
• Knowledge of third-party billing, including 1500 claim forms, CPT, and ICD-10
• One to three years of relevant experience in insurance follow-up for professional/hospital billing
• Experience with Epic preferred
• Technical proficiency in Microsoft Excel, Outlook, and Teams applications