Insurance Follow Up Specialist, Senior

Job description

The Insurance Follow-up Specialist- Senior completes follow-up activities on outstanding insurance medical claims for Medicare, Medicaid, Commercial, and Specialty insurance/program payors for a subset of multiple specialties. Analyze, screen, and update high complexity or escalated claim issues. Process appeals, write-offs, and determine if patient billing is necessary. May mentor newer team members. - Initiates insurance follow-up on unresolved appealed or unpaid claims to ensure maximum and timely reimbursement for Medicare, Medicaid, Commercial, or Specialty insurance/program payors, with a focus on complex insurance denials. - Verify patient benefits and insurance eligibility, perform claims status verification, navigate through insurance websites for specific payor guidelines, and effectively communicate findings to insurance companies, management teams, and clinical departments. - Assist the customer service team in resolving high-complexity and/or escalated patient billing concerns or disputes. - Review and respond to insurance correspondence letters related to recoupments, refunds, eligibility, or additional requests from payors. - Analyze daily claim rejections, screen cl...