[Remote] Insurance Follow-Up Representative II

Note: The job is a remote job and is open to candidates in USA. RemoteHunter is connecting candidates with an opportunity to manage insurance claims for hospital clients in a remote role. The position involves ensuring timely resolution and payment processing while handling denials, appeals, and account follow-up to support the financial success of healthcare organizations.

Responsibilities

• Submit medical claims according to federal, state, and payer guidelines
• Review and correct claim edits, errors, and denials to ensure proper submission and payment
• Research and analyze claim errors and rejections for corrections
• Investigate, follow up with payers, and collect assigned insurance accounts receivable
• Maintain knowledge of payer updates and process changes to ensure accurate claims handling
• Assess reasons for payer non-payment and take necessary actions to resolve claims
• Escalate stalled claims to payers or leadership
• Verify and adjust claims to reflect correct client account liability and balance
• Identify payer-specific issues and communicate to the team and manager
• Perform other duties as assigned to meet business needs

Skills

• High school diploma or equivalent
• One year experience in inpatient/outpatient medical billing and follow-up within a hospital or vendor setting securing insurance payments or accounts receivable resolution
• One year experience with hospital and/or physician claim follow-up and appeals with health insurance companies
• Experience with EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or comparable platforms
• Proficiency with Microsoft Office Suite, Teams, GoToMeeting, Zoom, and other computer applications
• Knowledge of ICD-10 Diagnosis, CPT/HCPCS codes, and healthcare revenue cycle rules and regulations
• Skilled in medical accounts investigation and payment validation
• Ability to make decisions independently and maintain professionalism
• Ability to learn and use collaboration tools and messaging systems
• Ability to maintain a positive demeanor and act in the best interest of the organization and clients
• Ability to take responsibility for quality and timeliness of work with minimal supervision
• Background check and exclusion verification required

Benefits

• Paid time off
• 401(k) plan
• Health insurance including medical, dental, and vision
• Life insurance
• Paid holidays
• Training and development opportunities
• Wellness and work-life balance support

Company Overview