Insurance Follow-Up Specialist (Remote) - Eastern Time & Central Time

About the Role: The Insurance Follow-Up Specialist is responsible for hospital and physician billing follow-up activities focused on resolving unpaid, underpaid, denied, or rejected insurance claims. This role works directly with Medicare, Medicaid, private payers, and commercial insurance carriers to investigate claim issues, facilitate prompt payment, and reduce outstanding accounts receivable. Success in this role requires strong knowledge of patient billing, claims submission, payer-specific requirements, denial management, reimbursement practices, and insurance follow-up processes. The Insurance Follow-Up Specialist partners with insurance carriers, patients, clients, and internal revenue cycle teams to resolve claim challenges and maximize reimbursement for our healthcare partners.

Title: Insurance Follow-Up Specialist

Location: Remote, Work-From-Home – United States

Schedule: Monday – Friday, 8:00 AM - 5:00 PM Central or 8:00 AM – 5:00 PM Eastern Department: Insurance

Reports To: Insurance Supervisor

Compensation: $18-$22 per hour

Key Responsibilities: Research and resolve denied, unpaid, underpaid, or incorrectly processed insurance claims. Investigate claim rejections and denials by contacting insurance carriers and reviewing payer requirements. Follow up with Medicare, Medicaid, Blue Cross, and commercial insurance carriers to obtain claim status updates and payment resolution. Analyze denial codes, remittance advice, payer correspondence, and claim documentation to identify root causes and determine appropriate next steps. Correct claim errors and facilitate claim resubmission to support timely reimbursement. Prepare and submit appeals, reconsiderations, corrected claims, and supporting documentation as needed. Manage assigned claim inventory and prioritize accounts to reduce aging accounts receivable. Contact patients when necessary to obtain or verify information needed to resolve billing or insurance issues. Review and update patient demographics, insurance information, and account details when necessary to facilitate claim resolution. Document all account activity, payer communications, and claim resolutions accurately and timely. Communicate professionally with insurance companies, patients, and client representatives regarding outstanding claims and balances. Identify denial trends and recurring issues and communicate findings to leadership and operational teams. Meet established productivity, quality, and cash collection performance standards. Maintain compliance with HIPAA regulations, client requirements, and company policies. Collaborate with Billing, Claims, Collections, and Client Services teams to resolve complex reimbursement issues.

Required Qualifications: High School Diploma or GED 2+ years of experience in insurance follow-up, denials management, accounts receivable (AR) follow-up, medical billing, healthcare collections, or related healthcare revenue cycle functions Experience working with Medicare, Medicaid, and commercial payers Experience with hospital billing and/or physician billing processes Experience verifying insurance eligibility, benefits, authorizations, and resolving payer-related claim issues Knowledge of patient billing, claims submission, reimbursement, denial resolution, and follow-up processes Experience using Epic within healthcare revenue cycle systems Proficiency with Microsoft Office (Outlook, Word, and Excel)

Preferred Qualifications: 3+ years of healthcare revenue cycle, insurance follow-up, denial management, or medical billing experience Experience in a hospital, physician practice, or healthcare revenue cycle environment Experience using Cerner, Meditech, or other healthcare information systems Experience obtaining prior authorizations and navigating payer-specific requirements Experience utilizing payer portals such as Availity, NaviNet, Experian Health, or similar platforms Knowledge of medical terminology, CPT, HCPCS, and ICD-10 coding principles Previous remote healthcare revenue cycle experience Work From Home RequirementsThis is a work-from-home position. Employees are expected to perform their job duties from a secure and private workspace within their home that protects confidential company and client information. Because employees may access protected health information (PHI), financial information, and other sensitive data, work must be performed in an environment where information cannot be viewed or overheard by others. To be successful in this role, employees must have: A secure and private workspace within their home A reliable wired (preferred) high-speed internet connection Minimum internet speeds of 30 Mbps download and 10 Mbps upload The ability to maintain a professional and distraction-free work environment during scheduled working hours As part of our hiring process for work-from-home positions: Candidates will participate in video interviews Video interviews may be recorded and transcribed to support candidate evaluation, interviewer collaboration, and hiring decisions Candidates may be asked to complete and provide the results of an internet speed test during the interview process to verify minimum technical requirements Employment eligibility: Candidates must be legally authorized to work in the United States at the time of hire The company does not provide employment visa sponsorship for this position As a condition of employment, a pre-employment background check will be conducted At this time, we are unable to consider candidates residing in the state of New York for this position