Job Description

Position Overview:

We are seeking a detail-oriented and proactive Insurance Follow-Up Representative to join our team. This position is responsible for the timely and efficient collection of government or commercial account receivables. The ideal candidate will possess strong knowledge of EOB (Explanation of Benefits) forms, be able to analyze reasons for claim denials, and take necessary steps to resolve accounts. The role also involves reviewing open accounts and actively engaging in resolution efforts through inquiry and follow-up with insurance carriers.

This position offers a dynamic work environment, with a mix of remote and onsite work, providing flexibility for candidates who are comfortable with self-management and proactive problem-solving.

Key Responsibilities:

• Review and understand Explanation of Benefits (EOB) to identify reasons for claim denials.
• Resolve account issues by investigating discrepancies and following up with appropriate parties (insurers, patients, internal teams).
• Manage a portfolio of commercial/government payer accounts ensuring timely follow-up and resolution.
• Analyze accounts and escalate issues as necessary to ensure a timely resolution and meet financial goals.
• Document and track communications, resolutions, and adjustments in the system.
• Collaborate with team members and managers to improve resolution processes and maintain compliance standards.

Job Requirements:

• Experience: 3+ years of hospital business office, medical billing, or related experience.
• Software Proficiency: Strong experience using Epic for claims management and processing.
• Knowledge: Understanding of commercial/ government payer programs (Medicare/Medicaid), business office procedures, patient billing, or collections/reimbursement in a healthcare setting.
• Technical Skills: Proficient in Microsoft Office, with emphasis on Excel, 10-key, and math for data analysis and reporting.
• Communication: Excellent written and verbal communication skills to effectively manage follow-up communications with insurers and other stakeholders.

Preferred Skills:

• Ability to multi-task in a fast-paced, high-volume environment
• Strong organizational skills and attention to detail

Work Environment:

• Team Size: 40 employees, split across 2 teams (Government and Commercial)
• Remote/Onsite Work: Work from home 4 days a week, with 1 onsite day (typically Wednesday)
• Training: The first 1-2 weeks will be conducted onsite for training and onboarding

Selling Points:

• Join a top-tier nationally recognized healthcare system
• Competitive compensation with attractive remote flexibility.
• Work with a dedicated team to make a difference in patient billing and reimbursement within a respected organization.

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