claims follow up specialist

CodeMax Medical Billing

<div>Reports to: Claims Supervisor
Employment Status: Full-Time
FLSA Status: Non-Exempt
Work Location: On-site - Fort Lauderdale, FL
Job Summary:
To ensure a timely and accurate collection of medical claims. The Claims Specialist will work closely with insurance companies to rectify payment denials, settle disputes, and receive due reimbursements. The ideal candidate will possess strong communication skills, a deep understanding of medical billing and coding, and the determination to resolve outstanding claims.
Duties/Responsibilities:<ul><li>
Reviews and work on unpaid claims, identifying and rectifying billing issues.</li><li>
Communicate with insurance companies regarding any discrepancy in payments if necessary.</li><li>
Conducts research and appeals denied claims timely.</li><li>
Reviews Explanation of Benefits (EOBs) to determine denials or partial payment reasons.</li><li>
Provides detailed notes on actions taken and the next steps for unpaid claims.</li><li>
Collaborate with the billing team to ensure accurate claim submission.</li><li>
Maintains a comprehensive understanding of the insurance follow-up process, payer guidelines, and compliance requirements.</li><li>
Resubmits claims with necessary corrections or supporting documentation when needed.</li><li>
Tracks and documents trends related to denials and work towards a resolution with the billing team.</li><li>
Assist patients with inquiries related to their insurance claims, providing clear and accurate information.</li><li>
All other duties assigned by the department supervisor and/or management team.</li></ul>
Required Skills/Abilities:<ul><li>
Proficiency in healthcare billing software.</li><li>
Strong analytical, organizational, and multitasking skills.</li><li>
Excellent verbal and written communication abilities.</li><li>
Ability to navigate payer websites and use online resources to resolve outstanding claims.</li></ul>
Education and Experience:<ul><li>
High school diploma or equivalent required.</li><li>
Prior experience in medical billing collections or a similar role.</li><li>
Knowledge of medical terminology, CPT and ICD-10 coding is a plus.</li><li>
Knowledge of HIPAA and other healthcare industry regulations.</li></ul>
Benefits<ul><li>
Health Insurance</li><li>
Vision Insurance</li><li>
Dental Insurance</li><li>
401(k) plan with matching contributions</li></ul>
CodeMax is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
CodeMax is a participating employer in the federal E-Verify program.</div>

Claims Follow-Up Specialist

Telelinkz

We are looking for an experienced Accounts Receivable (AR) Executive with strong analytical skills and deep understanding of U.S. medical billing workflows. The ideal candidate will manage claim follow-ups, identify underpayments, resolve denials, and ensure maximum reimbursement for our clients.Key Responsibilities:<ul><li>Perform daily AR follow-up with insurance companies to ensure timely payments.</li><li>Analyze aging reports and prioritize claims based on payer and aging bucket.</li><li>Work denials and rejections; initiate appeals with payers as needed.</li><li>Identify trends in non-payment, partial payments, and denials.</li><li>Coordinate with billing and coding teams to prevent recurring issues.</li><li>Maintain accurate documentation of all follow-up activities in the EHR/PM system.</li><li>Meet daily productivity and quality benchmarks set by management.</li></ul>Requirements:<ul><li>Minimum 2+ years of experience in U.S. medical billing AR follow-up.</li><li>In-depth knowledge of EOBs, ERAs, denials, and claim life cycle.</li><li>Strong understanding of payer policies (Medicare, Medicaid, BCBS, Commercial).</li><li>Familiar with EHRs such as Athena, eCW, AdvancedMD, CharmHealth, or Kareo.</li><li>Excellent English communication skills (verbal and written).</li><li>Strong analytical, time management, and problem-solving abilities.</li></ul>Job Type: Full-timePay: Rs70,000.00 - Rs90,000.00 per monthAbility to commute/relocate:<ul><li>Lahore: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>It's an on-site night shift position and timings are from 8pm to 5am , Are you willing to do work during this time slot ?</li></ul>Education:<ul><li>Bachelor's (Required)</li></ul>Experience:<ul><li>Medical Billing: 1 year (Required)</li></ul>Work Location: In person

AR / Medical Billing Executive

HiredFirst

<div><h2 class="jobSectionHeader">Billing Follow Up Associate</h2><ul><li>
Duration: 13 weeks</li><li>
Shift Details: Day Shift, M-F 8am-5pm, remote need, location is for Roseville. Looking for candidates with Follow Up experience of 2 years or more with either Medicare or Managed Medicare experience. Portal knowledge, basic denial experience, professional claim experience desired as well as EPIC experience</li><li>
Shift Type: 1st 8h</li><li>
Location: Roseville, CA</li><li>
Unit: RC PFS - Follow Up</li><li>
$850/week</li></ul> 

#Workwolf</div>

Billing Follow Up Associate

Upbound Group

<div><div>Location:
<div>5501 Headquarters Dr, Plano, Texas, 75024, United States of America</div></div><div><div><div><div> 
</div></div></div></div><div><div><div>Claims Specialist &ndash; Corporate Risk &amp; Safety
Location: Plano, TX
Position Summary
The Claims Specialist supports the Corporate Risk &amp; Safety organization by assisting with low‑severity liability and property claims and providing day‑to‑day administrative and coordination support across claims intake, documentation, vendor follow‑up, safety programs, reporting, and insurance activities. This role works closely with internal partners, our Third‑Party Administrator (TPA), and other suppliers to ensure claims and risk processes are completed accurately, consistently, and in alignment with Company standards.
Key Responsibilities:
Liability Claims Management &amp; Oversight<ul><li>
Support intake and setup of General Liability, Auto Liability, Property Damage, and Store Property Loss claims, ensuring required information is captured.</li><li>
Contact internal parties, claimants, plaintiffs, and witnesses involved in a matter.</li><li>
Assist with basic liability and exposure review and escalate higher‑risk matters to team members.</li><li>
Support review of reserve and settlement recommendations from the Third‑Party Administrator (TPA) by confirming documentation and routing items for approval.</li><li>
Review and assess claim files (notes, emails, invoices, and supporting documentation) to audit and ensure claim processing.</li></ul>
Litigation &amp; TPA Coordination<ul><li>
Assist with logging lawsuit notices and coordinating timely reporting and assignment to the TPA and defense counsel.</li><li>
Track litigation matters and review routine status updates for internal stakeholders.</li><li>
Attend claim and litigation calls with TPAs and counsel as needed; capture notes and action items for follow‑up.</li><li>
Support discovery by gathering internal documents, organizing records, and routing draft responses for review.</li></ul>
Property Claims &amp; Financial Support<ul><li>
Manage store property loss and property damage claims, including collecting estimates and coordinating vendor follow‑up.</li><li>
Support processing of claim payments and vendor invoices by validating required documentation and submitting items for approval.</li><li>
Assist with reconciliation support (tracking, documentation, and follow‑ups) related to claim expenses and Risk Management accounts.</li><li>
Respond to routine internal questions by researching claim documentation and escalating complex allocation issues as needed.</li></ul>
Safety &amp; Driver Risk Programs<ul><li>
Support the Motor Vehicle Report (MVR) monitoring program, including reviewing notifications, tracking license issues, and assisting with &ldquo;Do Not Drive&rdquo; agreement administration.</li><li>
Monitor driver license status and follow up until issues are resolved.</li><li>
Support vehicle‑related safety programs, including motorist observation reporting and decal administration.</li><li>
Participate in vehicle safety reviews and ongoing corporate safety initiatives.</li></ul>
Reporting, Analytics &amp; Compliance<ul><li>
Maintain and track reporting related to claim activity, litigation, costs, and trends.</li><li>
Assist with dashboards, leadership presentations, audits, actuarial reviews, and compliance requests by gathering data and preparing materials for review.</li><li>
Maintain internal Risk Management documentation and resources.</li></ul>
Insurance &amp; Vendor Support<ul><li>
Assist with certificates of insurance and policy administration.</li><li>
Support annual insurance renewal processes across liability, property, workers&rsquo; compensation, and specialty programs.</li><li>
Assist with surety bonds and insurance ID cards.</li><li>
Support activities with TPAs, brokers, safety vendors, and outside counsel as requested.</li></ul>
Qualifications:
Required<ul><li>
1&ndash;4 years of experience in claims, insurance, risk management, or an administrative/operations role (internship or related experience accepted).</li><li>
Ability to support claims investigation practices, documentation standards, and vendor coordination processes.</li><li>
Strong organizational skills, with the ability to manage multiple priorities.</li><li>
Proficient in Excel, PowerPoint and other standard business applications.</li><li>
Clear, professional written and verbal communication skills.</li></ul>
Preferred<ul><li>
Associate&rsquo;s or Bachelor&rsquo;s degree in Business, Finance, Risk Management, or related field.</li><li>
Exposure to claims, litigation support, safety programs, or driver risk monitoring.</li><li>
Experience working with service providers (e.g., TPAs, brokers, repair vendors) and strong customer service skills.</li></ul>
Sponsorship:
Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment visa at this time.</div></div></div></div><div></div>

Claims Specialist – Corporate Risk & Safety

Addison Group

Job Overview We are seeking a dynamic and detail-oriented Medical Billing Specialist to join our healthcare team. In this vital role, you will be responsible for managing the entire billing process, ensuring accurate coding, timely submission of claims, and effective follow-up on outstanding accounts. Your expertise will help optimize revenue cycle management while maintaining compliance with industry standards. This position offers an exciting opportunity to contribute to efficient healthcare delivery through precise medical billing practices.Responsibilities<ul><li>Prepare and submit insurance claims using appropriate coding systems such as CPT (Current Procedural Terminology), ICD-9, and ICD-10 codes.</li><li>Review medical records and documentation to ensure accuracy and completeness for billing purposes.</li><li>Verify patient insurance coverage and eligibility before submitting claims.</li><li>Follow up on unpaid or rejected claims through effective medical collection strategies.</li><li>Maintain detailed records of billing activities within Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems.</li><li>Collaborate with healthcare providers to clarify diagnoses or procedures requiring accurate DRG (Diagnosis-Related Group) coding.</li><li>Ensure compliance with healthcare regulations and industry standards related to medical coding and billing.</li></ul>Requirements<ul><li>Proven experience in medical office settings or healthcare billing environments.</li><li>Strong knowledge of medical terminology, medical records management, and billing procedures.</li><li>Familiarity with DRG, CPT coding, ICD-9, ICD-10, and ICD coding systems.</li><li>Experience working with EMR/EHR systems for documentation and billing purposes.</li><li>Excellent attention to detail and organizational skills to manage multiple claims efficiently.</li><li>Ability to interpret complex medical documentation and translate it into accurate billing codes.</li><li>Effective communication skills to coordinate with providers, insurance companies, and patients. Join our team as a Medical Billing Specialist and play a crucial role in ensuring smooth financial operations while supporting quality patient care!</li></ul>Pay: $34.39 - $59.37 per hourBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Retirement plan</li></ul>Work Location: In person

Medical Billing Specialist

Jordan Young Institute

<div>Title: AR Follow-up and Denial Specialist
Location: Onsite &ndash; Virginia Beach, VA (Hybrid)
Who we are:
Aligned Orthopedic Partners is a well-respected private orthopedic team comprised of highly trained, board-certified orthopedic surgeons devoted to delivering patients with the highest orthopedic care possible. Our commitment to finding the best solutions for individual needs sets us apart from the competition. We take pride in providing exceptional care while remaining friendly, courteous, and efficient.
Aligned Orthopedic Partners is recruiting an experienced AR Follow-up and Denial Specialist. The ideal candidate is experienced with analyzing and resolving insurance claim denials, correcting errors, and securing accurate reimbursement from payers. This role requires strong analytical, coding, and communication skills, with a focus on denial prevention, timely appeals, and collaboration across the revenue cycle team.
What you will do:
Claims Review &amp; Correction<ul><li>
Review denied and unpaid claims to verify coding and billing accuracy.</li><li>
Correct errors and submit revised claims when necessary.</li><li>
Investigate claims with no payer response to confirm receipt and follow up.</li></ul>
Denial Management &amp; Appeals<ul><li>
Analyze denials and generate effective, well-researched written appeals.</li><li>
Appeal denials through coding review, contract interpretation, medical record review, and direct payer interaction.</li><li>
Maintain detailed knowledge of payer websites and appeal processes for commercial and government payers.</li><li>
Ensure appeals and reconsideration requests are completed accurately and on time.</li></ul>
Trend Analysis &amp; Communication<ul><li>
Identify recurring denial trends or payer policy changes affecting reimbursement.</li><li>
Communicate trends to management and recommend process improvements to prevent reoccurrence.</li><li>
Support and participate in process and quality improvement initiatives.</li></ul>
Collaboration &amp; Education<ul><li>
Confer with coders, billing staff, and revenue cycle managers on coding or claim issues.</li><li>
Provide education to team members on payer policies and denial prevention.</li><li>
Collaborate on special projects and assist management with additional tasks as assigned.</li></ul>
Account Reconciliation<ul><li>
Work assigned follow-up queues, including identification of missing payments, overpayments, and credits on accounts.</li><li>
Document all actions taken in the practice management system.</li></ul>
What you bring to the table:
You are a detail-oriented and dependable professional with a strong grasp of accounts receivable and denial processes. You take ownership of your work, communicate clearly, and consistently meet deadlines in a fast-paced environment. You bring:<ul><li>
Minimum of 3 years&rsquo; experience in a medical billing department (orthopedic or surgical experience strongly preferred).</li><li>
In-depth knowledge of healthcare billing, claims processing, payer follow-up, and appeals.</li><li>
Proficiency with payer websites, Microsoft Outlook, Word, and Excel.</li><li>
Coding knowledge sufficient to process denied claims and support appeals.</li><li>
Strong reasoning, critical thinking, analytical, and mathematical skills.</li><li>
Ability to work independently with high productivity and attention to detail.</li><li>
CPC certification preferred but not required.</li><li>
High School Diploma or GED required.</li></ul>
Equal Opportunity Employer
Aligned Orthopedic Partners is an equal opportunity employer. We promote diversity of thought, culture, and background. We celebrate what makes us different and committed to building a team that represents a variety of experiences. All employment is decided on the basis of qualifications, merit, and business need.</div>

AR Follow-up and Denial Specialist

Simpson General Hospital

<div>Join Our Team at Simpson General Hospital!
Position: Medical Billing Specialist 
Location: Business Office Financial Services 
Schedule: MondayFriday | 8:00 AM 4:30 PM | Full-Time 
Reports to: Business Office Director
At Simpson General Hospital (SGH), we pride ourselves on delivering high-quality healthcare in a warm, hometown environment. We're currently seeking a Medical Billing Specialist to join our Financial Services team. If you're detail-oriented, experienced in healthcare billing, and passionate about supporting patient care behind the scenes, we'd love to hear from you!<h3 class="jobSectionHeader">
Position Summary:</h3>
The Medical Billing Specialist is responsible for preparing insurance claims, following up on denials, and ensuring accurate billing through patient demographic and insurance updates. This role involves regular communication with patients, families, insurance companies, and internal departments.<h3 class="jobSectionHeader">
Essential DutiesResponsibilities:</h3><ul><li>
Edit and submit UB and 1500 claim forms</li><li>
File insurance claims and follow up on billing work queues</li><li>
Correct and rebill claims as needed</li><li>
Assist with claims data for audits</li><li>
Provide excellent customer service</li><li>
Demonstrate professionalism aligned with SGH's mission and values</li><li>
Comply with HIPAA, infection control, and safety guidelines</li><li>
Perform other duties as assigned</li></ul><h3 class="jobSectionHeader">
Qualifications:</h3><ul><li>
Education: High School Diploma or GED (Required); Associate degree (Preferred)</li><li>
Experience: 
<ul><li>
35 years in a healthcare billing/business office setting (Preferred)</li><li>
Proficiency in Microsoft Word, Excel, and customer service</li></ul></li><li>
Strong communication and interpersonal skills</li><li>
Knowledge of claims submission for Medicare, Medicaid, and major insurers</li><li>
Efficient data entry and reconciliation skills</li><li>
Ability to work independently and meet deadlines under pressure</li><li>
Familiarity with healthcare laws and regulations</li></ul><h3 class="jobSectionHeader">
Physical Requirements:</h3><ul><li>
Clear speech and hearing for effective communication</li><li>
Visual acuity for close and distant tasks</li><li>
Occasionally lift up to 25 lbs.</li></ul><h3 class="jobSectionHeader">
Benefits Include:</h3><ul><li>
Health Insurance</li><li>
Dental Insurance</li><li>
Vision Insurance</li><li>
Company-paid Life and AD&amp;D Insurance</li><li>
Supplemental Insurance Options</li><li>
403(b) Retirement Plan</li><li>
Paid Time Off (PTO)</li><li>
Sick Time Off (STO)</li><li>
Discounted In-House Services at SGH ClinicsHospital</li></ul><h3 class="jobSectionHeader">
Ready to Apply?</h3>
Be part of a team that values accuracy, compassion, and community care. Apply today and help us continue providing exceptional service to our patients and families!</div>

Billing Specialist

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