[Hiring] Medical Insurance Follow-Up Specialist @Revco Solutions Inc

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Medical Insurance Follow-Up Specialist is responsible for ensuring the timely and accurate resolution of outstanding insurance claims, with a primary focus on Blue Cross Blue Shield accounts. This role involves: • Investigating and resolving unpaid or underpaid claims by communicating with insurance carriers • Identifying billing issues and initiating corrective actions • Maximizing reimbursement and supporting the overall revenue cycle • Maintaining detailed documentation and adhering to regulatory and payer-specific guidelines Duties & Responsibilities: • Conduct detailed analysis and follow-up on outstanding insurance claims (both commercial and government), ensuring timely and accurate resolution in accordance with payer guidelines. • Research and resolve claim denials, rejections, and underpayments by initiating appropriate billing corrections, appeals, and resubmissions. • Prepare and submit claim documentation—including EOBs, itemized statements, and medical records—as required by payers to support claim adjudication. • Respond to payer and patient inquiries related to delinquent claims, maintaining compliance with privacy regulations and payer contract guidelines. • Utilize payer portals, Electronic Health Records (EHR), and patient accounting systems to investigate claim status, post notes, and manage follow-up activities. • Identify trends in denials and payment delays, contributing to process improvement initiatives and strategies for reducing AR days. • Maintain accurate and detailed records of account activity, ensuring that production goals and quality standards are consistently met or exceeded. • Demonstrate strong communication skills when interacting with insurance representatives, patients (as appropriate), and internal departments to resolve outstanding issues. • Prioritize and organize daily workload effectively to meet departmental benchmarks in a fast-paced, high-volume environment. • Provide support on special projects and additional assignments as requested by management. Qualifications • 2 years of previous experience working with commercial or other third-party insurance claims, medical billing/follow-up, BCBS experience is a plus • An understanding of various forms, codes (CPT & ICD), insurance terminology and insurance company remittance advice • EPIC experience preferred but not required • Certificates, Licenses, Registrations, and/or Medicare certification are a plus, but not required Requirements • 2 years of previous experience working with commercial or other third-party insurance claims, medical billing/follow-up, BCBS experience is a plus • An understanding of various forms, codes (CPT & ICD), insurance terminology and insurance company remittance advice • EPIC experience preferred but not required • Certificates, Licenses, Registrations, and/or Medicare certification are a plus, but not required Salary Description $18-21/hr. Apply Now Apply Now