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Claims Follow-Up Specialist

1 month ago

Fort Wayne, United States Creative Financial Staffing Full time

Do you have a passion for problem-solving, a knack for numbers, and a love for the healthcare industry? Join our team as a Medical Claims Follow-Up Specialist and help us ensure that every claim gets the attention it deserves
This is an On Site position

About Us: We are dedicated to providing exceptional healthcare services and administrative support. Our team is a lively, dedicated group that values collaboration and innovation. We believe in creating an environment where every team member can thrive. If you're looking for a fun and rewarding career, you've come to the right place

Key Responsibilities of the Claims Follow-Up Specialist:

  • Conduct follow-up on unpaid or denied medical claims to ensure timely and accurate reimbursement.
  • Review and analyze Explanation of Benefits (EOBs) to determine reasons for denials or underpayments.
  • Resubmit corrected claims and provide additional documentation as necessary.
  • Communicate with insurance companies, patients, and healthcare providers to resolve claim issues.
  • Maintain accurate and organized records of all claim follow-up activities.
  • Collaborate with the billing and coding team to ensure proper coding and claim submission practices.
  • Assist with Accounts Receivable management and ensure timely collection of outstanding balances.
  • Stay updated on industry regulations, insurance guidelines, and coding changes.

Qualifications of the Claims Follow-Up Specialist:

  • High school diploma or equivalent required; associate's degree in healthcare administration, finance, or related field preferred.
  • Minimum of 2 years of experience in medical billing, coding, and claims follow-up.
  • Strong understanding of medical billing and coding practices, including ICD-10, CPT, and HCPCS codes.
  • Proficiency in medical terminology and healthcare insurance processes.
  • Experience with Accounts Receivable in a medical setting.
  • Excellent analytical and problem-solving skills.
  • Strong attention to detail and organizational abilities.
  • Exceptional communication and interpersonal skills.
  • Ability to work independently and as part of a dynamic team.
  • Proficiency in medical billing software and electronic health record (EHR) systems.


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