Healthcare Billing Claims Follow Up Specialist

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Requirements:

• Must have a minimum of 3-5 years of hands-on experience in a fast-paced medical billing environment
• Proven ability in collections and negotiation is highly preferred
• Must have successful track record of adjudicating out of network claims and issues
• Must have previous experience in a healthcare setting
• Must have previous experience with CPT and ICD-10
• Must have solid PC and application skills
• The ability to handle a very high volume of work with speed and accuracy is essential
• Must have the ability to understand and apply contract language to billing
• Must have the ability to communicate in a professional manner internally and with payers.
• Must have experience in complex denials and appeal processes

Responsibilities:

• Responsible for the follow-up on unpaid or rejected insurance claims for assigned carriers and will work with insurance companies, and/or staff to resolve account issues.
• Responsible for submitting corrected claims for the team
• Responsible for the escalation appeal process for complex rejected claims, going above and beyond to support clients and families in need.
• Responsible for complex claim issues.
• Responsible for any escalation projects assigned by direct manager.