Insurance Follow-up Representative II
Novant Health, Charlotte, NC, United States
Insurance Follow-Up Representative II
Denials (Back-End)
Position Summary: The Insurance Follow-Up Representative II is responsible for resolving denied or unpaid insurance claims by performing detailed analysis, payer follow-up, and corrective actions. This role focuses on back-end revenue cycle operations, ensuring timely reimbursement and compliance with payer requirements. Key Responsibilities:
Review and analyze denied claims to determine the root cause of denial Identify why claims were denied and determine appropriate steps needed for resolution (e.g., corrections, appeals, resubmissions) Maintain strong knowledge of payer-specific guidelines, policies, and requirements Follow internal workflows and processes, including Novant-specific payer processes and escalation protocols Interpret and understand Explanation of Benefits (EOBs) and remittance advice to identify discrepancies Perform timely insurance follow-up on outstanding or denied claims Meet productivity standards of approximately 6 invoices per hour, focusing on denial resolution Initiate and handle outbound calls to insurance companies to resolve claim issues Utilize payer web portals to check claim status, submit reconsiderations, and obtain necessary documentation Manage workers' compensation claims and no-response accounts, ensuring appropriate follow-up actions Collaborate across multiple specialties and institutional accounts to resolve complex billing issues Document all follow-up activities accurately in the billing system Required Skills & Qualifications:
Strong understanding of medical billing and revenue cycle management, especially back-end processes Experience handling insurance denials and appeals Ability to read and interpret EOBs and payer communications Familiarity with commercial, government, and workers' compensation payers Excellent communication and problem-solving skills Ability to multitask and meet productivity benchmarks in a fast-paced environment Proficiency with billing systems, payer portals, and standard office software Education: Education: High School Diploma or GED, required. Experience: Minimum one year of medical insurance experience, required. Additional Skills/Requirements (required): Good verbal and written communication skills. Experience operating computers/laptop. Clear and pleasant speaking voice on the telephone, hearing acuity that allows for understanding over the telephone, prolonged sitting, visual abilities and manual dexterity that allows the use of PCs for extended periods of time. Ability to operate 10 key keyboard. Ability to drive/travel to multiple locations/facilities as needed. Ability to work from home as needed. Additional Skills/Requirements (preferred): Basic accounting and medical terminology. Job Opening ID 156040
Denials (Back-End)
Position Summary: The Insurance Follow-Up Representative II is responsible for resolving denied or unpaid insurance claims by performing detailed analysis, payer follow-up, and corrective actions. This role focuses on back-end revenue cycle operations, ensuring timely reimbursement and compliance with payer requirements. Key Responsibilities:
Review and analyze denied claims to determine the root cause of denial Identify why claims were denied and determine appropriate steps needed for resolution (e.g., corrections, appeals, resubmissions) Maintain strong knowledge of payer-specific guidelines, policies, and requirements Follow internal workflows and processes, including Novant-specific payer processes and escalation protocols Interpret and understand Explanation of Benefits (EOBs) and remittance advice to identify discrepancies Perform timely insurance follow-up on outstanding or denied claims Meet productivity standards of approximately 6 invoices per hour, focusing on denial resolution Initiate and handle outbound calls to insurance companies to resolve claim issues Utilize payer web portals to check claim status, submit reconsiderations, and obtain necessary documentation Manage workers' compensation claims and no-response accounts, ensuring appropriate follow-up actions Collaborate across multiple specialties and institutional accounts to resolve complex billing issues Document all follow-up activities accurately in the billing system Required Skills & Qualifications:
Strong understanding of medical billing and revenue cycle management, especially back-end processes Experience handling insurance denials and appeals Ability to read and interpret EOBs and payer communications Familiarity with commercial, government, and workers' compensation payers Excellent communication and problem-solving skills Ability to multitask and meet productivity benchmarks in a fast-paced environment Proficiency with billing systems, payer portals, and standard office software Education: Education: High School Diploma or GED, required. Experience: Minimum one year of medical insurance experience, required. Additional Skills/Requirements (required): Good verbal and written communication skills. Experience operating computers/laptop. Clear and pleasant speaking voice on the telephone, hearing acuity that allows for understanding over the telephone, prolonged sitting, visual abilities and manual dexterity that allows the use of PCs for extended periods of time. Ability to operate 10 key keyboard. Ability to drive/travel to multiple locations/facilities as needed. Ability to work from home as needed. Additional Skills/Requirements (preferred): Basic accounting and medical terminology. Job Opening ID 156040