Claims Follow Up Specialist

Job Summary

Working remotely in a full-time capacity, the Claims Follow Up Specialist will manage electronic denials, paper denials, and unpaid claims reports to resolve issues with claims denied or unpaid by insurance carriers.

Key responsibilities

• Correct and resubmit claims in the clearinghouse portal and billing system while directing rejected claims to appropriate departments
• Review denied claims for correction or resubmission, utilizing multiple online resources to research and resolve issues
• Follow up on unpaid claims with insurance carriers, processing appeals and identifying denial trends for reporting

Required qualifications

• 1-2 years of experience in Accounts Receivable Follow-Up
• Experience with Professional CMS 1500 Billing and multiple billing systems
• Knowledge of various states' billing requirements and commercial/government payers
• Basic understanding of medical billing and health insurance carrier reimbursement policies
• Proficiency in Microsoft Office applications, including Teams, Outlook, and Excel