Insurance Follow-up Specialist

About Our Client

The organization operates within the healthcare revenue cycle management sector, addressing challenges related to billing and collections for hospitals and physician practices. It acts as an intermediary between medical institutions, patients, and insurance agencies to streamline claims processing, reimbursement, and denial management.

About the Opportunity

The Insurance Follow-up Specialist is responsible for managing billing and collections processes by reviewing insurance claims and resolving outstanding issues with insurance companies. This role ensures accurate reimbursements, manages denials, and supports the financial operations of healthcare providers by facilitating timely claim resolutions.

Responsibilities

• Work proactively with insurance companies to negotiate, research, and resolve complex billing and claims issues for hospitals and physician practices
• Analyze open accounts and outstanding claims within specialized practice management systems and internal databases to accelerate resolution
• Perform technical billing reviews and strategic denial follow-up across assigned payer claims to maximize collected revenue
• Contact commercial and government payers directly via phone or online portals to resolve unpaid or underpaid claims after a comprehensive account review
• Identify systemic process bottlenecks, track root causes of denials, and escalate complex payer issues when necessary
• Participate actively in continuous training sessions to enhance domain knowledge across the healthcare revenue cycle management lifecycle
• Resolve intricate patient account issues by conducting thorough investigations of historical system comments and account ledger transactions
• Maintain an up-to-date working knowledge of client-specific policies, compliance guidelines, and changing workflow documentation
• Consistently meet or exceed operational quality and production standards established by departmental management
• Absolutely maintain data integrity across collections database records
• Assist leadership with tracking priority reports and maintaining absolute data integrity across collections database records
• Mentor newly onboarded employees, answer workflow questions, and assist in their day-to-day operational training
• Comply fully with all organizational policies, data privacy standards, and federal HIPAA regulations

Requirements

• Foundational knowledge of medical billing and insurance terminology, including practical familiarity with CPT, ICD-9, ICD-10, HCPCS codes, as well as co-pay, deductible, and co-insurance structures
• Clear structural understanding of institutional hospital and professional physician billing and adjudication processes
• Strong working familiarity with Medicaid, Medicare, commercial payer guidelines, and federal HIPAA compliance requirements
• Minimum of 2–3 years of progressive professional experience directly within healthcare denials management, medical collections, or accounts receivable (A/R) follow-up
• Digital proficiency with standard office software, internet platforms, and electronic health record (EHR) or billing systems
• High school diploma or equivalent secondary education certification is required
• Excellent analytical skills, attention to detail, and professional verbal and written communication habits for negotiating with insurance payers

Pay Range and Compensation Package

The target compensation for this position is highly competitive and will be determined dynamically based on the final candidate's depth of medical billing experience, specific A/R tracking skills, and relevant qualifications. A comprehensive overview of the available benefits package, health coverage options, and wellness perks will be shared transparently with selected candidates during the initial screening call.

Equal Opportunity Statement

Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.