Job Summary:

The Insurance Follow Up Specialist III is responsible for researching and resolving issues with unpaid, denied or rejected insurance claims. This position will take the required actions in order to facilitate prompt payment from the insurance payer. This individual in this role will also work to ensure that billing practices are ethical and in compliance with government regulations and guidelines.

Job Responsibilities:

• Follow up with insurance companies regarding claims.
• Ensure account balances are correct and assigned to the appropriate insurance or patient bucket. Process adjustments or transfers as needed.
• Resubmit corrected claims with supporting documentation as appropriate.
• Research and review insurance denials from insurance companies.
• Complete and submit reconsideration requests or appeals to insurance companies.
• Document all follow up activity in EMR.
• Review payer reports to make sure accounts are paid appropriately to reduce the total company accounts receivables.
• Perform related duties as assigned within scope of practice.
• Responsible for working on complex denials.
• Act as a point of escalation and monitor supervisory or secondary work queues.
• Work with complex insurance payers to ensure payments.
• Assist supervisor/manager with monitoring inbound phone calls, call queue wait times and other assigned functions.
• Assists with training support of new hires.

Job Requirements:

• High school graduate or GED certificate is required.
• A minimum of 2 years’ experience in a physician billing or third-party payer environment.
• Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.
• Candidate must demonstrate the ability to understand and navigate the payer adjudication process.
• Patient financial and practice management system experience in Epic and or other of electronic billing systems is preferred.
• Knowledge of medical terminology is preferred.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Ranges: $27.40 - $36.06

Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.

61st Street Service Corporation

At 61^st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.

We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws. Please be advised that the corporation requires COVID-19 vaccinations for all employees unless an exemption request for a disability / medical or religious accommodation has been approved.