Insurance Follow Up Representative

About the role

As an Insurance Follow Up Representative, you will resolve unpaid insurance claims and collect outstanding balances from third-party payers. You will review denials, initiate follow-up with insurers, rectify billing errors, submit appeals, and negotiate for maximum reimbursement. Success requires understanding billing regulations, strong problem-solving skills, and effective communication to optimize revenue recovery.

Responsibilities

• Follow up with insurance payers to research and resolve unpaid insurance accounts receivable.
• Make necessary corrections in the practice management system to ensure appropriate reimbursement for all providers.
• Interpret Explanation of Benefits (EOBs) and remittance advices to verify correct and appropriate payment.
• Communicate effectively over the phone and through written correspondence to explain outstanding, denied, or underpaid balances using accurate reasoning based on EOBs, reimbursement, and payer-specific requirements.
• Resubmit claims with necessary information via paper or electronic methods when requested.
• Anticipate potential areas of concern within the follow-up function, identify issues or trends, and conduct staff training to address and rectify them.
• Recognize when additional assistance is needed to resolve insurance balances and escalate appropriately through defined communication and escalation channels.

Requirements

• High School Graduate or GED upon hire.

Qualifications

• Preferred: Graduation from a post-high school program in medical billing or other business-related field.
• Preferred: Two years of revenue cycle or related work experience demonstrating requisite job knowledge and abilities.

About the employer

CommonSpirit Medical Group (Mountain Management Services) is a leading provider of comprehensive office management services and affiliated physicians in Southeast Tennessee and North Georgia. This award-winning, faith-based organization supports exceptional healthcare delivery in the region and has been consistently recognized for excellence by organizations such as U.S. News & World Report, PINC AI™, CMS, Healthgrades®, Leapfrog, and as one of the Best Places to Work in Tennessee.

Pay

$16.42 - $23.19 per hour.