Insurance Rep, SBO

3 weeks ago

Chattanooga, United States North American Credit Services Inc Full time
Insurance Follow-up Representative, SBO

About MedSrv

As the healthcare industry continues to grow, so does the need for consistent, effective Revenue Cycle Management. But it takes more than just technology and technical expertise. It takes innovation, a willingness to adapt, and passion to deliver the best. MedSrv, LLC is the difference in Revenue Cycle Management.

We’re looking for an Insurance Follow-up Representative to join our growing team. As a professional with experience in handling insurance claims and denials, it is imperative to address correspondence denials and conduct insurance follow-ups promptly and accurately. Proactive communication with insurance companies, healthcare providers, and patients is key to resolving any issues or discrepancies quickly and maintaining positive relationships within the healthcare industry. Keeping detailed records of all communications and actions taken will help to track progress, analyze trends, and continuously improve processes for more efficient claim resolution in the future. If you're ready to contribute to our mission of guiding by faith and serving with integrity and compassion, we want to hear from you Join the MedSrv team and be part of a company committed to excellence in Revenue Cycle Management.

Schedule: Full-time

Location: Remote

Compensation: $18.00/hr.

Benefits for you and your family:
  • Paid time off
  • Full benefits package
  • Matching 401k plan
  • Balanced work-life schedule – NO WEEKENDS
  • Casual work environment
  • Career Development
In this role, you will:

Timely and precise follow-up is crucial in ensuring that claims are processed efficiently, and reimbursements are received in a timely manner. By thoroughly reviewing denial letters, identifying the reasons for denial, and providing necessary documentation or information to support the claim, you can effectively overturn denials and maximize reimbursement opportunities.

You will bring value to the team by:
  • Properly works Work Queue, to determine corrections needed; re-bill claims within 3-5 days of practice corrections being made. Email Department Manager if unable to meet this timeframe.
  • Properly works Work Queue by calling insurance payers when necessary to resolve patient disputes, or ensure questionable claims are processed correctly, rebill, appeal claims where and when necessary
  • Use available resources to identify missing insurance payments as needed and send them to the proper Work Queue.
  • Properly works Work Queue from CS Team to review and determine course of action to resolve patient question, issue or dispute these may involve:
    • Tertiary Billing
    • W9 Insurance Requests
    • Wellness vs. Office visit review, send to coding work queue as necessary
    • Take insurance calls and handle properly.
    • WC / MVA – file claims, and take calls from insurance adjusters as necessary
    • Patient refund request
    • Merge accounts
    • Police Custody
    • Duplicate billed services
    • Time spent with provider
    • Surgical procedures
    • Verify if paid out of network correctly
    • Change account to Self-Pay Rate
  • Meet productivity standards as set by management.
  • Send communication to the practice as needed for additional information or corrections to be made by the client with appropriate details of what is needed. Review, work or forward correction communication as needed when received from the practice.
  • Responsible for forwarding information to manager and providing any updates to client contact information.
  • Must know the client specialties, locations, and proper A/R information.
  • Communicate claim trends resulting in denials or a decrease in payments. This information is to be sent to management with the payer, provider(s), number of claims and dollar amount affected.
  • Keeps management informed of client problems in communication and correspondence.
  • A new employee must be able to meet the established and agreed upon goals within 90 days of continuous employment.
Requirements you must have for success:
  • High school diploma or equivalent
  • A minimum of one year experience and/or training; or equivalent combination or education and experience required.
  • Must have the ability to get along with others in a close office setting.
  • Must work efficiently at home meeting requirements.
  • Must have the ability to concentrate for extended periods of time.
  • Must be willing to function and cooperate as member of a team.


Language Skills:

Ability to: read and comprehend complex instructions, correspondence, and memos; write and present information to leadership, vendors, clients, and other employees of the organization.

Mathematical Skills:

Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Have the ability to compare rate, ratio, and percent and to draw and interpret various graphs.

Reasoning Ability:

Ability to: deal with problems involving several concrete variables in standardized situations; plan, organize, delegate, and prioritize work; provide clear and effective direction to staff; communicate effectively orally and in writing; establish and maintain effective working relationships with MedSrv departments, vendors, other businesses, and our clients; Must be able to multi-task.

Physical Demands:

You may be required to lift between 30-50lbs at times. Limited.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually moderate.

We are an equal-opportunity employer and believe in the power of a diverse, inclusive team. We welcome all applications from all suitably qualified people, regardless of race, sex, disability, religion/ belief, sexual orientation, or age. Please let us know if you require anything which would enable your success throughout our interview process.

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