Description Full-time and Part-time positions availableIn Office - Hybrid - Remote positions availablePOSITION OVERVIEW:MUST HAVE 2 YEARS MINIMUM HOSPITAL IN-PATIENT AND OUT-PATIENT CLAIMS FOLLOW-UP EXPERIENCEReporting to the Client Billing Team Leader, the Insurance Claims Follow-up Specialist must have a strong knowledge of medical collections, denial processing, appeal submission, and EOB review. This position is responsible for resolving outstanding in-patient and out-patient facility claims not paid.KEY RESPONSIBLITIES:The ideal candidate will possess strong expertise in the following areas:
- Insurance billing, follow-up, and verification.
- Review of correspondence, including refund requests and medical necessity documentation.
- Conducting detailed follow-ups with insurance providers.
- Investigating accounts requiring additional action and resolving issues with insurance companies on unpaid claims.
- Responding to claim denials and verifyng reimbursements according to payer contracts.
EXPERIENCE IN THE FOLLOWING AREAS IS REQUIRED:
- Denial Management
- Writing and submitting appeals.
- Correcting claims (e.g., NDC or coding issues.)
- Claims status follow-up.
- Correcting and resubmitting denied claims using systems such as Cerner, EPIC, or A2K.
- Retro authorizations (Retro Auth)
- Payment and balance reclassification
- Utilizing the Change Healthcrae billing portal
Offered Salary: Up to $32.00 per hour (based on experience)Position Requirements QUALIFICATIONS/REQUIREMENTS:
- Strong attention to detail and excellent communication skills (both written and verbal.)
- Proven ability to interact effectively with insurance companies and patients.
- Self-motivated with ability to work independently.
- Experience with insurance verification processes and carrier websites.
- For remote position - candidates must have reliable high-speed internet.
- All work hours must be completed during our regular scheduled workday hours (8am to 5pm EST.)
- Must meet all productivity and performance standards.
Offered Salary: Up to $32.00 per hour based on experience Full-Time/Part-Time Full-Time and/or Part-Time Shift Days Company Website www.pomr.com Rate of Pay Up to $32.00 per hour based on experience Position Experienced Insurance Claims Follow-up Specialist EOE Statement We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. This position is currently accepting applications.