Managed Care Follow Up Specialist

Job Summary

To support a growing healthcare practice, the full-time remote Managed Care Follow Up Specialist will monitor and track the status of submitted appeals and disputes, ensuring timely follow-up and accurate resolution while managing a high-volume caseload.

Key responsibilities

• Review outstanding hospital reconsiderations and appeals for potential resolution within policy guidelines
• Manage claims resolution workflows, including 2nd level appeals and monitoring appeals for payment
• Demonstrate knowledge of HIPAA privacy standards and ensure compliance with system PHI privacy practices

Required qualifications

• Associate degree in Business Administration, Healthcare Administration, or a closely related field with 2 years of relevant work experience
• Minimum of two years in medical collections
• Basic understanding of the Revenue Cycle Process
• Experience with payor online portals
• Basic knowledge of Microsoft Applications: Outlook, Excel, Word