Medical Claims Resolution Specialist

5 days ago


Reading, Pennsylvania, United States Annuity Health Full time

We are Annuity Health, a leading healthcare provider dedicated to delivering exceptional patient care. We are seeking a highly skilled Insurance Follow-Up Representative to join our team.

Job Summary

The Insurance Follow-Up Representative will be responsible for ensuring timely and accurate payment from insurance companies for hospital and physician services. This includes reviewing accounts, following up on claim status, gathering missing information, rebilling, appeals, and billing secondary claims as needed.

Duties and Responsibilities

  • Provide top-notch customer service to healthcare contract customers
  • Prepare and collect payments from Medi-Cal and other contracted health insurance payers
  • Research remits and Explanation of Benefits (EOBs) for complete and accurate payments or denials
  • Provide additional information when required and submit corrected claims or appeals
  • Request adjustments when necessary and identify items requiring client assistance
  • Gather payor trends and provide feedback
  • Perform other duties as assigned by management

Requirements

  • MEDICAL BILLING EXPERIENCE REQUIRED; EPIC PREFERRED
  • Familiarity with Microsoft Office and knowledge of government and non-government billing guidelines for facilities and physicians
  • Strong understanding of account/claim status, resolution, and appeals process; knowledge of UB04 and HCFA forms
  • Excellent customer service, time management, verbal, written, and electronic communication skills
  • A high school diploma or General Education Development (GED) certificate is required; one to two years of college preferred
  • A minimum of three years of experience in medical billing and insurance collections or healthcare revenue cycle is preferred

Salary Range: $60,000 - $80,000 per year, depending on qualifications and experience. Benefits include health insurance, retirement plan, and paid time off.



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