Insurance Follow-Up Specialist
Remote (U.S.)Full-TimeMiddle
Salary22 - 25 USD per hour
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Job Details
- Experience
- 5+ years' experience
- Required Skills
- Microsoft ExcelMicrosoft Office Suite
Requirements
- 5+ years' experience in healthcare billing, claims, or insurance follow-up.
- Strong knowledge of ICD-10, CPT, HCPCS, and payer policy nuances.
- Hands-on experience with Medicare collections for specialty drug coverage, including using Medicare portals and filing determinations and appeals.
- Proven success in collections with Blue Cross payers, including BCBS FL, Independence BC, and BCBS TX preferred.
- Experience working with Medicaid and other commercial insurance plans.
- Familiarity with reimbursement regulations, managed care contracts, and denial resolution strategies.
- Detail-oriented with strong analytical and critical thinking skills.
- Proficient in Microsoft Office Suite (Outlook, Teams, Excel, etc.).
Responsibilities
- Investigate and resolve insurance claim denials with speed and accuracy—typically 50 to 100 denials daily.
- Partner with payers to resolve issues and secure timely reimbursement.
- Interpret LCD/NCD requirements and manage CPT/HCPCS-related denials.
- Coordinate with front desk and authorization teams to reduce delays and optimize collections.
- Provide top-tier phone support to patients, insurance companies, and internal teams.
- Work in payer portals (NaviNet, Availity, Medicare portals, and others) and clearinghouses to ensure efficient claim submission.
- Deliver timely and compliant follow-up to meet revenue cycle goals.
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