Insurance Billing And Follow Up Specialist

Contract position, hybrid work arrangement, based out of Tigard, OR.

Responsibilities

• Process and submit clean insurance claims to Medicare, Motor Vehicle Accident (MVA), Workers’ Compensation, and other insurance payers, ensuring accuracy and compliance with payer requirements.
• Conduct thorough follow-up on unpaid, denied, or rejected claims to maximize reimbursement and resolve outstanding balances promptly.
• Research, analyze, and resolve claim denials by identifying root causes and implementing corrective actions, including timely appeals when necessary.
• Verify patient insurance coverage and benefits prior to service to ensure eligibility and accurate billing.
• Maintain detailed and accurate documentation of all billing activities, claim statuses, and communications with insurance payers.
• Monitor aging reports regularly, prioritizing follow-up actions based on claim age, payer responsiveness, and fi ling deadlines.
• Navigate complex payer systems and portals to check claim status, update information, and facilitate payment resolution.
• Communicate professionally and effectively with insurance representatives to address payment issues, clarify policies, and negotiate resolutions.
• Collaborate with clinical departments and providers to obtain additional documentation or correct coding as needed to support claims.
• Stay current with insurance billing regulations, payer-specific guidelines, and coding updates to ensure ongoing compliance and optimal reimbursement.
• Other duties as assigned.

Qualifications

• High school diploma required; Associate’s degree in Healthcare Administration, Medical Billing, or a related field preferred.
• 2+ years of experience in medical billing, with direct experience processing Medicare, Motor Vehicle Accident (MVA), and Workers’ Compensation claims.
• Strong knowledge of medical terminology and medical coding systems, including CPT, ICD-10-CM, and HCPCS.
• Proficiency in medical billing software and electronic health record (EHR) systems, with the ability to navigate payer portals and claims platforms.
• Solid understanding of insurance verification processes, coverage guidelines, and pre-service eligibility checks.
• Excellent analytical and problem-solving skills, with keen attention to detail in claim review, denial resolution, and data entry.
• Strong written and verbal communication skills, with the ability to communicate effectively with payers, providers, and internal teams.
• Ability to work independently, manage competing priorities, and meet deadlines in a fast-paced billing environment.
• Certification as a Certified Medical Billing Specialist (CMBS) or equivalent credential preferred.

Skills

• Customer service
• Medical billing
• Claim
• Insurance billing
• Insurance eligibility

Pay

$24.00 - $27.00/hr

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short