Claims Follow Up Specialist

Job Summary

To support the resolution of denied and unpaid claims, the full-time Claims Follow Up Specialist will manage electronic and paper denials, utilize various resources to resolve unpaid claims, and collaborate with other departments to ensure proper handling of claims in a remote work environment.

Key responsibilities

• Correct and resubmit claims in the clearinghouse portal and billing system, directing rejected claims to other departments as needed
• Review denied claims for correction and resubmission, utilizing online resources to research and identify denial trends
• Follow up on unpaid claims with insurance carriers and process appeals on denied claims to ensure timely resolution

Required qualifications

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