Insurance Specialist
New
A
Adaptive BiotechnologiesBiotechnology
Location: Remote (WFH)Full-TimeMiddle
SalaryHourly Rate: $22.74 - $27.79
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Job Details
- Experience
- 2 years of experience in insurance follow up, denial management, medical billing, or revenue cycle operations.
- Required Skills
- Microsoft Office SuiteHIPAA
Requirements
- High school diploma.
- 2 years of experience in insurance follow up, denial management, medical billing, or revenue cycle operations.
- Strong knowledge of insurance billing processes, denial codes, and payer follow up workflows.
- Excellent verbal and written communication skills.
- Strong problem solving and analytical abilities.
- Proficiency with billing systems and Microsoft Office Suite.
- Detail oriented with strong organizational skills.
- Ability to manage multiple priorities independently in a fast-paced environment.
- Critical thinker with a proactive approach to issue resolution.
Responsibilities
- Review and analyze delayed or denied claims to determine root cause based on payer explanation of benefits or remittance advice.
- Conduct timely follow up with insurance carriers to clarify claim status, resolve issues, and secure payment.
- Obtain missing information, correct coding or billing errors, and submit corrected claims or resubmissions when appropriate.
- Research and interpret payer coverage policies, contracts, and medical necessity requirements related to molecular and NGS testing.
- Document all follow up activity, payer communication, and resolution steps accurately and timely within the billing system.
- Partner closely with prior authorization, billing, reimbursement, and client services teams to resolve claim discrepancies.
- Manage incoming single-case agreements or LOAs and negotiate appropriate reimbursement rates.
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