Insurance Follow Up Rep

Insurance Follow Up Rep

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.

As our Insurance Follow Up Rep, you will be a crucial asset in our revenue cycle management team, responsible for corresponding with commercial and government health insurance payers. Your primary function will be to research and resolve outstanding insurance balances and non-coding denials, ensuring correct reimbursement for services rendered. This role directly contributes to the financial health of our ministry by safeguarding revenue integrity and maintaining compliance with established guidelines.

Every day you will engage in comprehensive follow-up activities, including phone calls, online processing, fax, and written correspondence to address unpaid or underpaid claims. You'll expertly analyze Explanation of Benefits (EOBs) and remittance advices, effectively communicating with payers to explain balances and resubmit claims with necessary information. This role also involves identifying potential areas of concern or trends, proactively rectifying issues, and escalating complex cases to management, ensuring meticulous documentation of all actions in the billing system.

To be successful in this insurance claims specialist role, you will need a minimum of two years of revenue cycle or related work experience, demonstrating a strong understanding of medical insurance, payer contracts, CPT, and ICD codes. Your ability to troubleshoot and adapt to diverse situations, maintain confidentiality, and exhibit excellent customer service skills, including professional telephone interactions, is paramount. We're seeking a detail-oriented, analytical thinker who can effectively prioritize tasks and thrive in a fast-paced environment, contributing to our mission of providing compassionate and efficient healthcare by ensuring proper financial follow-up.