Healthcare Billing Claims Follow Up Specialist

Position: Claims Follow Up Specialist

Job Type: Full Time 

Location: Remote (CO / IL / MD / VA) 

Schedule: Monday to Friday 8:30am to 5:00pm

Compensation: $20-24 Per Hour  

About The Role 

The Claims Follow Up Specialist is responsible for resolving complex insurance claims by providing daily problem resolution with insurance carriers. The goal is to recover the maximum revenue possible on each unpaid account. Reviews and provides technical direction or recommendations on claims of various complexity. Handles projects for complex claims and/or payers as assigned by the Claims Manager.

Key Responsibilities:

• Responsible for the follow-up on unpaid or rejected insurance claims for assigned carriers and will work with insurance companies, and/or staff to resolve account issues. 
• Responsible for submitting corrected claims for the team 
• Responsible for the escalation appeal process for complex rejected claims, going above and beyond to support clients and families in need. 
• Responsible for complex claim issues.  
• Responsible for any escalation projects assigned by direct manager.

Experience Requirements:

• Must have a minimum of 3-5 years of hands-on experience in a fast-paced medical billing environment 
• Must have previous experience in a healthcare setting 
• Must have previous experience with CPT and ICD-10 
• Must have solid PC and application skills 
• The ability to handle a very high volume of work with speed and accuracy is essential 
• Proven ability in collections and negotiation is highly preferred 
• Must have the ability to understand and apply contract language to billing  
• Must have the ability to communicate in a professional manner internally and with payers. 
• Must have experience in complex denials and appeal processes

Other Requirements:

• Candidates applying for this position should be aware that an offer for employment in this position is contingent upon passing a comprehensive background check, encompassing criminal records and motor vehicle reports.

The Perks

At Sandstone Care, we believe that great care starts with our employees. That’s why we offer a comprehensive benefits package to support you in your personal and professional journey. Some of the benefits include:

• A competitive compensation and total rewards package including a meaningful hourly rate, bonus incentive programs, merit-based pay increases, and professional growth opportunities.
• A …