Insurance Follow-up Denial Specialist I

Job not on LinkedIn

🔥 0 minutes ago

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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