Insurance Follow-Up Specialist

What You’ll Do

• Investigate and resolve insurance claim denials with speed and accuracy—typically 50 to 100 denials daily.
• Partner with payers to resolve issues and secure timely reimbursement.
• Interpret LCD/NCD requirements and manage CPT/HCPCS-related denials.
• Coordinate with front desk and authorization teams to reduce delays and optimize collections.
• Provide top-tier phone support to patients, insurance companies, and internal teams.
• Work in payer portals (NaviNet, Availity, Medicare portals, and others) and clearinghouses to ensure efficient claim submission.
• Deliver timely and compliant follow-up to meet revenue cycle goals.

What We’re Looking For

• 5+ years’ experience in healthcare billing, claims, or insurance follow-up.
• Strong knowledge of ICD-10, CPT, HCPCS, and payer policy nuances.
• Hands-on experience with Medicare collections for specialty drug coverage, including using Medicare portals and filing determinations and appeals.
• Proven success in collections with Blue Cross payers, including BCBS FL, Independence BC, and BCBS TX preferred
• Experience working with Medicaid and other commercial insurance plans.
• Familiarity with reimbursement regulations, managed care contracts, and denial resolution strategies.
• Detail-oriented with strong analytical and critical thinking skills.
• Proficient in Microsoft Office Suite (Outlook, Teams, Excel, etc.).
• A team player with a proactive mindset and a passion for patient-centered outcomes.