Follow Up Specialist
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Job Description
Follow Up Specialist resolving electronic denials, unpaid claims, and appeals for Ovation Healthcare. Researching payer portals and coordinating claim resolution for independent healthcare providers.
Responsibilities:
- Work on electronic denials, paper denials, and unpaid claims reports to resolve denied or unpaid claims across insurance carriers
- Correct and resubmit claims in clearinghouse portals and billing systems
- Direct rejected and denied claims to other departments for resolution when warranted
- Identify denial trends and report them to the lead to help prevent future denials
- Open cases and work directly with clearinghouses when claim rejections are received in error
- Review denied claims for correction and resubmission
- Research denied claims using payer websites and online portals
- Follow up on unpaid claims with insurance carriers after the specified claim age
- Contact insurance companies by telephone, portals, and email to resolve payment issues
- Research claims using multiple online websites and portals
- Process appeals on denied claims
Requirements:
- 1-2 years' experience in an AR Follow-Up
- Experience in Professional CMS 1500 Billing, Multiple Clearinghouses, Billing Systems, and EMRs
- Knowledge of Multiple States Billing Requirements, Commercial and Government Payers
- Basic Medical Billing Knowledge
- Basic Health Insurance Carrier billing & reimbursement policies
- Problem solving & dispute resolution
- Ability to multitask and adapt to changing regulations
- Strong verbal and written communication skills
- Excellent organizational and time-management abilities
- Proficiency in Microsoft Office apps such as Teams, Outlook, and Excel
- Ability to handle multiple tasks and prioritize effectively
- High attention to detail and problem-solving skills
- Expected to work from a designated home office or other quiet and secure location, free from distractions
- Reliable internet access and a suitable workspace
- Ability to sit for long periods while working at a desk or computer
- Regular use of a keyboard, mouse, and other computer peripherals
Benefits:
- Comprehensive health and wellness benefits such as medical, dental, vision, life insurance, short and long-term disability coverage
- HSA with employer contributions
- Flexible spending accounts for health care and dependent care accounts
- Wellness platform with premium incentives
- Employee assistance support
- Voluntary supplemental plans including accident, critical illness, hospital indemnity, and child disability insurance
- Robust and flexible paid time off offerings
- Company paid holidays
- 401(k) plan with discretionary employer match opportunities
- Professional development opportunities
- Company issued equipment
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