Insurance Follow Up Rep
Job Summary and Responsibilities
You will resolve unpaid insurance claims and collect outstanding balances from third-party payers. Your daily tasks include reviewing denials, initiating follow-up with insurers, rectifying billing errors, submitting appeals, and negotiating for maximum reimbursement.
- Understand billing regulations
- Possess strong problem-solving skills
- Communicate effectively to optimize revenue recovery
- Follows-ups with insurance payers to research and resolve unpaid insurance accounts receivable
- Makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers
- Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices
- Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements
- Resubmits claims with necessary information when requested through paper or electronic methods
- Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify
- Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels
Job Requirements
- Required: High School Graduate, upon hire or High School GED, upon hire
- Preferred: Other Graduation from a post-high school program in medical billing or other business-related field and Two years of revenue cycle or related work experience
Where You'll Work: CommonSpirit Medical Group (Mountain Management Services) is a leading provider of comprehensive office management services and affiliated physicians in Southeast Tennessee and North Georgia. Our award-winning, faith-based organization is dedicated to supporting the delivery of exceptional healthcare in the region. We are proud to be consistently recognized for excellence by organizations like U.S. News & World Report, PINC AI™, CMS, Healthgrades®, Leapfrog, and as one of the Best Places to Work in Tennessee. We are honored to be your trusted ally in health, dedicated to serving our community with compassion and excellence.