insurance 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

Medical City Healthcare

<div><h5 class="jobSectionHeader">Introduction</h5><h5 class="jobSectionHeader">
This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).
Do you want to join an organization that invests in you as a Medical Insurance Collector? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.</h5><h5 class="jobSectionHeader">
Job Summary and Qualifications</h5><h5 class="jobSectionHeader"> 
The Healthcare Insurance Collector is responsible for performing account follow-up and resolution of insurance and patient receivables. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you. We want you to apply today! 
What you will do in this role:<ul><li> 
Work insurance pools and contact insurance companies to resolve claims that are not paid in a timely manner.</li><li>
Review EOB&rsquo;s, remits and payer correspondence while performing account follow-up and escalate any identified issues to the appropriate area for review and response to expedite claim resolution.</li><li>
Identify problem accounts and escalate as appropriate.</li><li>
Maintain compliance with pool completion requirements.</li><li>
Maintain required productivity and QA standards.</li><li>
Document in the patient account record to identify actions taken on the account.</li><li>
Work with patients and guarantors resolve payer requests and discrepancies to promptly resolve pending claims.</li></ul> 
 What qualifications you will need:<ul><li> 
Minimum of 1-year related experience required, preferably in healthcare. Relevant education may substitute experience requirement.</li><li>
Previous experience with Insurance Follow Up is preferred.</li><li>
This is a work from home position that requires high-speed internet with 25 MB Download and 15 MB Upload. Wifi is not permitted.</li><li>
Ability to work uninterrupted for shift (not including breaks/lunch)</li></ul></h5><h5 class="jobSectionHeader">
Benefits</h5>
Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:<ul><li>
Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services</li><li>
Wellbeing support, including free counseling and referral services</li><li>
Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence</li><li>
Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling</li><li>
Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing</li><li>
Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts</li></ul>
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
&quot;
Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.
HCA Healthcare has been recognized as one of the World&rsquo;s Most Ethical Companies&reg; by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
&quot; 
&quot;There is so much good to do in the world and so many different ways to do it.&quot;- Dr. Thomas Frist, Sr. 
HCA Healthcare Co-Founder 
If you find this opportunity compelling, we encourage you to apply for our Medical Insurance Collector opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing - apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.</div>

Medical Insurance Collector

FloMed Infusion Services LLC

<div>Description:

FloMed Infusion is an outpatient infusion clinic offering Medical Infusions and Injections in a relaxing ambulatory environment. For more specifics on what we do and who we are, please review our website https://flomedinfusion.com/
We are seeking an experienced Insurance Payor Collections Specialist. This role emphasizes precision in reviewing and evaluating insurance denials or returned claims. The candidate must effectively communicate with insurance companies and clients using a resolution-focused approach. Such communication should be guided by acquired knowledge, insurance carrier guidelines, company policies and procedures, as well as thorough research and collection efforts. Alongside claim follow-ups, the collection specialist will also be responsible for sending medical records and drafting appeals for denied claims to insurance companies.<ul><li>
Deliver exceptional customer service to clients while maintaining strict adherence to HIPAA privacy and confidentiality standards.</li><li>
Precisely and comprehensively document all relevant information and follow-up actions in the electronic records system.</li><li>
Monitor and follow up on processed claims to ensure timely and accurate payment to the agency.</li><li>
Collaborate directly with insurance payers to confirm client eligibility and determine financial responsibility, including co-pays, deductibles, co-insurance, and out-of-pocket maximums.</li><li>
Pursue follow-up actions on insurance denials, including initiating appeals and requesting reconsiderations as appropriate.</li><li>
Support all billing-related tasks and responsibilities tied to both insurance and client invoicing, as needed.</li><li>
Investigate rejected insurance claims thoroughly and take appropriate action to reprocess or appeal denied or underpaid claims.</li><li>
Detect and analyze patterns in claim denials, escalating persistent payment delays or systemic issues to senior management.</li><li>
Communicate with insurance companies to resolve outstanding account balances and expedite claim resolution.</li></ul>
Requirements:
<ul><li>Proven experience in medical collections or accounts payable/receivable is preferred.</li><li>
Strong understanding of financial concepts, accounting principles, and revenue cycle management.</li><li>
Excellent phone etiquette with the ability to communicate effectively with clients.</li><li>
Proficiency in financial software and accounting software for managing accounts.</li><li>
Knowledge of debits, credits, and account analysis is essential.</li><li>
Strong math skills for calculating payments, balances, and adjustments.</li><li>
Ability to work independently while managing multiple accounts efficiently.</li><li>
A commitment to maintaining confidentiality and compliance with industry regulations. Join our team as a Collection Agent where your skills will contribute significantly to our financial health while helping clients navigate their payment responsibilities.</li></ul>
Job Type: Full-time
Benefits:
401(k) matching
Dental insurance
Health insurance
Paid time off
Vision insurance
Experience:
collections: 1 year (Required)
Ability to Commute:
Delray Beach, FL 33446 (Required)</div>

Billing Specialist

Family Love Care

Intake Specialist (Hybrid)Kansas City, MO (Hybrid &ndash; One to two times per week in office)Weekly and monthly bonus potential!Position OverviewWe are seeking a motivated and detail-oriented Intake Specialist to join our growing home health care team. This role is responsible for managing incoming inquiries, converting callers into qualified leads, and guiding potential patients and caregivers through the intake process until services begin.The ideal candidate is empathetic, organized, and persistent with follow-up, as the intake process can take several weeks to months before converting to start of care. Success in this role requires strong communication skills and the ability to handle a high volume of calls while providing excellent service.Key Responsibilities<ul><li>Answer and manage high-volume inbound calls from prospective patients, families, and caregivers</li><li>Convert incoming inquiries into qualified leads for home health services</li><li>Conduct outbound follow-up calls, emails, and texts to nurture potential patients throughout the intake process</li><li>Maintain consistent communication with prospects during the typical 3-month intake and onboarding timeline</li><li>Track and update lead and patient information in internal systems</li><li>Provide clear information about services, eligibility, and next steps</li><li>Coordinate with internal teams to ensure a smooth transition from intake to start of care</li><li>Meet call activity and conversion goals</li></ul>Qualifications<ul><li>1+ year of experience in customer service, intake coordination, call center, healthcare scheduling, or sales support preferred</li><li>Strong communication skills via phone, email, and text</li><li>Comfortable handling 50+ inbound and outbound calls per day</li><li>Strong follow-up and organizational skills</li><li>Basic technical proficiency with computers, CRM systems, and scheduling tools</li><li>Ability to multitask in a fast-paced, patient-focused environment</li><li>Experience in home health, healthcare intake, or patient coordination is a plus</li></ul>What We&rsquo;re Looking For<ul><li>A compassionate communicator who enjoys helping families navigate care options</li><li>Someone who is persistent with follow-up and relationship building</li><li>A team player who thrives in a high-volume, fast-paced environment</li></ul>Pay: $20.00 - $23.00 per hourBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Vision insurance</li></ul>Experience:<ul><li>Call center: 1 year (Required)</li></ul>Ability to Commute:<ul><li>Kansas City, MO 64126 (Required)</li></ul>Work Location: Hybrid remote in Kansas City, MO 64126

Intake 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>

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

Prisma Health

<div>Inspire health. Serve with compassion. Be the difference.
Job Summary
Performs tasks of moderate to difficult complexity relating to both hospital and physician accounts. Handles a large volume of inbound calls. Responsible for also making outbound calls related to self-pay follow up on accounts. Assists patients with requests for information, complaints, and resolving issues. Responsible for data analysis and interpretation throughout all functions of revenue cycle, to determine reasons for denials, non-payment and overpayment, post/balance/correct electronic remittances, billing and follow-up of government payers and specialized accounts, analysis/correction of correct coding guidelines, preparation of accounts for appeal, review/analysis of insurance credit balances and analysis/movement of unapplied, unidentified, undistributed balances. Moderate to difficult levels of evaluation, analysis, decision making required in these roles.
Essential Functions<ul><li>
All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.</li><li>
Resolves billing concerns, addresses inquiries related to insurance concerns/matters, assist patients with MyChart while simultaneously establishing a rapport with our diverse field of patients. Reviews accounts to determine insurance coverage; obtains and corrects any missing or inaccurate information. Discusses patient responsibility, which includes educating patients on claim processing, deductible, coinsurance, and co-pays. Interacts with patients by making patients aware of payment options such as payment plans and financial assistance as well as how to apply for financial assistance if circumstance warrant. Ability to set up payment plans in MyChart based on patient's personal needs.
</li><li>Greets patients in a professional and courteous manner. Communicates clearly and professionally in both oral and written communication. Be clear and concise in all communication to ensure patients understand the information that is being communicated to them by the Customer Service Specialist. Maintains a high level of poise and professionalism in dealing with patients. Knows when to escalate a patient service issue real time. Research customer requests or issues, determines if further action is needed, forwards to appropriate party for resolution, and exercises good judgement to determine urgency of patient's need.
</li><li>Contacts payer and makes hard inquiries on account status if needed. Escalates problem accounts to the appropriate area(s). Documents billing activity on a patient's accounts according to departmental guidelines; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to departmental leaders. Properly documents accounts clearly with indicators and activities so that tracking and trending can be prepared for any potential further analysis if needed.
</li><li>Ensures all work is compliant with privacy, HIPAA, and regulatory requirements.</li><li>
Participates in general or special assignments and attends all required training. Adheres to policies and procedures as required by Prisma Health and follows all compliant regulatory payer guidance.
</li><li>Answers all incoming calls from Prisma Health patients
</li><li>Performs other duties as assigned.</li></ul>
Supervisory/Management Responsibilities<ul><li>
This is a non-management job that will report to a supervisor, manager, director or executive.</li></ul>
Minimum Requirements<ul><li>
Education - High School diploma or equivalent OR post-high school diploma / highest degree earned</li><li>
Experience - Two (2) years billing, bookkeeping, and/or accounting experience</li></ul> 
In Lieu Of<ul><li>
NA</li></ul>
Required Certifications, Registrations, Licenses<ul><li>
NA</li></ul> 
Knowledge, Skills and Abilities<ul><li>
Knowledgeable of the job functions required for a A/R Follow-up Representative, Cash Posting Representative, Claims Clearinghouse Representative, Correspondence Representative, Credit Processing Specialist, Denial/Appeals Specialist, Payment Research Specialist and a Quality Assurance Specialist.
</li><li>Knowledgeable of the entire Revenue Cycle and Epic.</li></ul>
Work Shift
Day (United States of America)
Location
Patewood Outpt Ctr/Med Offices
Facility
7001 Corporate
Department
70019935 System Billing Office
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.</div>

Single Billing Office Customer Service Representative, FT, Days, - Remote

Search 10000+ Insurance follow up specialist jobs near you this May. New roles added regularly across leading industries. Apply today.

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