Insurance Follow-up Denial Specialist I

Job not on LinkedIn

🕒 August 18

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🔒 Insurance

🚫👨‍🎓 No degree required

👻 Ghost score 12%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Optim Health System

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1976

🏥 Healthcare

🧘 Wellness

👥 B2C

Healthcare • Wellness • B2C

Optim Health System is a regional health system operating hospitals, ambulatory surgery centers, and clinics that specialize in orthopedic care, interventional pain management, neurosurgery, and primary care. The system emphasizes patient-focused, high-quality, and compassionate care, offering Centers of Excellence for joints, spine, and other musculoskeletal services, as well as imaging, rehabilitation, and surgical services across community hospitals and outpatient facilities.

📋 Description

• Process insurance and billing claims in a timely manner • Review electronic claims and submission reports • Resolve and resubmit rejected claims • Collaborate with Medical Records, Coding, Revenue Integrity, Patient Access, and Patient Financial Services to resolve claim errors • Process daily error logs, stalled reports, aging claims, and ad-hoc reports • Address insurance-company requests for additional information and billing-status checks • Work with insurance payers to ensure proper billing for assigned patient accounts • Maintain daily follow-up reports and work denials and underpayments • Assist Customer Service with patient concerns and questions • Produce correspondence to payers and patients regarding claim status and additional information • Review account documentation and determine actions needed for proper billing • Initiate billing and appropriate follow-up or collection steps • Document billing, follow-up, collection, and escalation actions • Process administrative and medical appeals, refunds, reinstatements, and insurance-claim rejections under supervision • Communicate with team members regarding assigned projects and process education • Monitor and assist team members, provide feedback, assist with training, audit work, and communicate progress • Provide continuing education on processes and accounts-receivable requirements • Verify caller authorization levels and pertinent information in accordance with HIPAA

🎯 Requirements

• Able to work with advanced billing procedures • Able to prioritize and multitask according to workload volume and deadlines • Knowledge of Revenue Cycle links among Charge Capture, Patient Access, HIM, Coding, and Patient Financial Services • Working knowledge of coverage, payment, compliance, and basic billing rules for Government and Managed Care payers • Ability to handle confidential personnel and patient-related information discreetly • Ability to give and follow written and verbal directions • Working knowledge of personal computer applications • Proficiency in Word, Excel, and PowerPoint • Professional and effective verbal and written communication in English • Ability to work with all departments and levels of management • One year of experience in a Revenue Cycle Department or related area such as registration, finance, collections, customer service, medical, or contract management • High school diploma or GED • Knowledge and adherence to HIPAA regulations

🏖️ Benefits

• No explicit benefits or compensation extras stated