Insurance Follow Up Specialist

Job Summary

Insurance Follow Up Specialist is responsible for insurance collections and follow up on unpaid and underpaid claims. This role focuses on claim status calls, denial resolution, appeals, and coordination of benefits to drive timely payment and keep A R clean.

Key Responsibilities

• Work assigned insurance A R by payer and timely filing priority
• Call payers for claim status, pending reasons, and payment timelines
• Resolve denials by correcting claims, requesting reconsiderations, and submitting appeals with supporting documentation
• Review EOBs and ERAs to identify underpayments and take next steps
• Research claim edits, medical necessity denials, and authorization issues and route clinical items when needed
• Complete coordination of benefits when payers request updated coverage details
• Submit corrected claims and follow up through final resolution
• Request and track refunds and recoupments when applicable
• Document all work clearly in the practice management system with accurate notes and next follow up date
• Meet daily productivity and quality expectations
• Support clean claim efforts by reporting trends that are causing denials or delays

Qualifications

Required

• 3 plus years of insurance collections experience in a medical office, physician billing, or revenue cycle setting
• Strong knowledge of claim follow up, denials, appeals, and payer portals
• Understanding of EOBs, ERAs, CPT, ICD 10, modifiers, and basic medical billing rules
• Experience working A R reports, aging, and timely filing limits
• Strong phone skills and ability to speak professionally with payer reps
• Solid documentation and account note habits
• Comfortable with high volume work and deadlines

Preferred

• Endocrinology, internal medicine, or specialty practice experience
• Experience with Availity, payer portals, and clearinghouse tools
• Experience with Medicare, Florida Blue, Humana, Aetna, Cigna, UnitedHealthcare, and Medicaid plans
• Experience with electronic appeals and medical records requests

Pay: $20.00 - $22.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person