Job Summary
We are seeking a proactive and detail-oriented Medical Claims Insurance Follow Up specialist to join our dynamic healthcare team. In this role, you will be responsible for managing and tracking outstanding insurance claims, ensuring timely follow-up with insurance companies, and resolving claim discrepancies. Your efforts will directly contribute to maximizing reimbursement, reducing claim denials, and maintaining accurate medical records. This position offers an exciting opportunity to utilize your medical coding expertise and insurance knowledge to support efficient revenue cycle management.
Duties
- Follow up on unpaid or denied insurance claims promptly and persistently to secure payment
- Review medical records, billing information, and claim documentation for accuracy and completeness
- Communicate effectively with insurance companies to clarify claim issues or discrepancies
- Utilize Electronic Medical Records (EMR) and Electronic Health Records (EHR) systems to track claim status updates
- Apply knowledge of DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology) coding, ICD-9, and ICD-10 codes to ensure proper claim submission and correction
- Collaborate with medical office staff to gather necessary medical records and documentation for claims processing
- Maintain detailed logs of follow-up activities, claim statuses, and resolution outcomes
- Identify patterns of claim denials or rejections and recommend process improvements for faster resolution
Skills
- Strong understanding of medical billing procedures, medical coding, including DRG, CPT coding, ICD-9, ICD-10, and ICD coding standards
- Experience with medical collection processes and resolving unpaid claims
- Proficiency in using EMR systems and EHR platforms for tracking claims and updating records
- Excellent knowledge of medical terminology and medical records management
- Must have knowledge with Insurance portals such as Availity, UHC, CIgna, Connex.
- Effective communication skills for liaising with insurance representatives, healthcare providers, and patients
- Attention to detail with a focus on accuracy in coding, documentation, and follow-up activities
Join our team if you’re passionate about ensuring accurate claims processing while supporting the financial health of our healthcare organization. Your expertise will help streamline operations, improve cash flow, and enhance patient satisfaction through diligent follow-up efforts.
Pay: $38,000.00 - $45,000.00 per year
Work Location: In person
