Insurance Follow-up Specialist

About Our Client

Founded in 2003, the organization operates in the healthcare management services industry, supporting healthcare providers and related organizations through revenue cycle management, administrative services, care coordination, and clinical research. With a global workforce of more than 35,000 employees across the United States, India, Colombia, and the Philippines, the organization combines healthcare expertise and technology to improve operational efficiency and financial performance for more than 350 healthcare entities.

About the Opportunity

The Insurance Follow-up Specialist supports revenue cycle operations by managing and resolving outstanding insurance claims for hospitals and physician practices. This role analyzes claims, investigates denials and account issues, communicates with insurance payers, and performs timely follow-up to facilitate accurate and efficient reimbursement. The position also contributes to process improvement, reporting, and team development while maintaining compliance with healthcare regulations and client requirements.

Responsibilities

• Contact insurance companies to resolve outstanding hospital and physician practice claims and account issues.
• Analyze denial and non-denial claims using practice management and internal systems.
• Perform technical billing and denial follow-up on assigned payer claims.
• Communicate with payers to resolve claims and facilitate appropriate payment, adjustment, or self-pay resolution.
• Investigate complex patient account issues by reviewing system timelines, reimbursements, transactions, and related documentation.
• Identify trends, recurring issues, and opportunities for process improvement and escalate concerns to supervisors as appropriate.
• Maintain current knowledge of client-specific policies, workflows, procedures, and documentation requirements.
• Participate in initial and ongoing training related to revenue cycle management processes.
• Assist management with priority reports and maintain accurate collections and account records.
• Mentor new employees and support training and development activities.
• Perform all responsibilities in accordance with company policies, HIPAA requirements, and applicable compliance standards.

Requirements

• High school diploma or equivalent.
• Minimum 2–3 years of experience in denials management, collections, accounts receivable, or insurance follow-up.
• Knowledge of medical and insurance terminology, including CPT, ICD-9, ICD-10, HCPCS, copayments, deductibles, and coinsurance.
• Understanding of hospital and physician billing processes.
• Familiarity with Medicaid, Medicare, and commercial insurance payers.
• Knowledge of HIPAA requirements and healthcare compliance practices.
• Proficiency with standard Microsoft Office and other office software.
• Strong analytical, organizational, communication, and problem-solving skills.
• Ability to manage multiple accounts and priorities while maintaining accuracy and productivity.
• Ability to work effectively both independently and as part of a team.

Benefits & Perks

• Health, dental, and vision coverage options.
• Voluntary insurance programs.
• 401(k) plan with employer match.
• Professional development and training opportunities.
• Paid time off and holiday pay.
• Eligibility for bonus programs, commissions, or other incentives depending on position, location, and tenure.