A Brief Overview Position responsible for submitting and resolving medical claims moderate to high complexity. Must remain current with governmental and third party billing, follow-up and appeal requirements for compliant billing and follow-up of both inpatient and outpatient claims for all wholly owned facilities and physician entities including internal and external policy requirements. What You Will Do - Responds to requests from management, staff, or physicians in a timely and appropriate manner. - Maintains patient and physician confidentiality and professionalism at all times. - Follow department policies and procedures to ensure accurate and timely claim resolution. - Effectively communicates utilizing telephone, form letters, e-mail, or internal correspondence to resolve patient inquiries and insurance issues. - Attends and participates in team meetings. - Utilizes worklists to review and analyze account balances in order to collect payment for medical services rendered. - Utilizes multiple system applications to review, update patient information as well as research and resolve outstanding AR balance. - Assists in the analysis of claims resolution and provides feedback to management for solutions and process improvements. - Performs follow up with insurance companies to ensure appropriate payment on claims, resolve denials, correct claims, and appeal claims. - Acts as a liaison with internal and external customers providing assistance in claims and receivables resolution in a high volume environment. - Documents accounts with clear and concise verbiage in accordance with departmental procedures. - Reviews and responds to correspondence and inquiries received. - Meets and exceeds team productivity and quality standards. - Takes the lead on special projects. - Participates in staff training. - Reviews complex claims issues for resolution and recommends process improvements. - Performs other related duties as assigned. Additional Responsibilities - Performs other duties as assigned. - Complies with all policies and standards. - For specific duties and responsibilities, refer to documentation provided by the department during orientation. - Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace. Education - High School Equivalent / GED (Required) and - Associate's Degree (Preferred) and - Bachelor's Degree (Preferred) Work Experience - 1+ years medical billing / claim experience (Required) and - Experience with medical billing software (Preferred) Knowledge, Skills, & Abilities - Must have a working knowledge of claim submission (UB04/HCFA 1500) and third party payers. (Required proficiency) - Knowledge of procedural and ICD10 coding. (Required proficiency) - Basic knowledge of medical billing terminology. (Required proficiency) - Detail-oriented and organized, with good analytical and problem solving ability. (Required proficiency) - Notable client service, communication, and relationship building skills. (Required proficiency) - Ability to function independently and as a team player in a fast-paced environment. (Required proficiency) - Must have strong written and verbal communication skills. (Required proficiency) - Demonstrated ability to use PCs, Microsoft Office suite (including Word, Excel and Outlook), and general office equipment (i.e. printers, copy machine, FAX machine, etc.). (Required proficiency) Physical Demands - Standing Occasionally - Walking Occasionally - Sitting Constantly - Lifting Rarely up to 20 lbs - Carrying Rarely up to 20 lbs - Pushing Rarely up to 20 lbs - Pulling Rarely up to 20 lbs - Climbing Rarely up to 20 lbs - Balancing Rarely - Stooping Rarely - Kneeling Rarely - Crouching Rarely - Crawling Rarely - Reaching Rarely - Handling Occasionally - Grasping Occasionally - Feeling Rarely - Talking Constantly - Hearing Constantly - Repetitive Motions Frequently - Eye/Hand/Foot Coordination Frequently Travel Requirements - 10%25

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection. Job Description A day in the life of a Field Property Adjuster, and what it takes to do the job!  As a Field Property Adjuster, you will provide exceptional service to our policyholders. Your primary responsibility will involve traveling to our customers' homes to conduct on-site inspections, investigate coverage, prepare estimates, and settle claims promptly and efficiently. Additionally, you will handle virtual claims countrywide, leveraging various platforms and software such as Xactimate and ClaimsX Video Collaboration. Your expertise will be particularly focused on water losses, ensuring our customers receive the highest level of support and resolution for these specific claims.    You'll wear a few hats that will require a level of experience:  - The Customer Service Expert –you’ll live into Allstate’s Claims Culture by caring, empowering, and restoring, and you will accomplish that by being compassionate, clear, and a committed partner in each claim. You lead with empathy, always.   - The Investigator – you’ll confidently and independently investigate property claims by performing detailed reviews of damage and interpreting policies to determine coverage.   - The Effective Communicator – you’ll use phone, emails and sometimes even video chat with customers to help them through a fast, fair, and easy claims process. You’ll also incorporate a specific approach to claim handling to offer the customer their preference of communication to efficiently discuss their claim needs and keep them updated on the claim progress.   - The Negotiator – You will evaluate and negotiate claims settlements with customers, vendors, third party carriers and claimants, in accordance with all legal and business standard methodologies. With negotiations, you will incorporate tactics in handling challenging and complex situations.  - The Problem Solver –you’ll utilize multiple tools to get the job done in a fast-paced environment, including estimate tools, job aids, and additional settlement platforms, all while using your sharp critical thinking skills.   - The Recorder – you’ll protect the company financially by executing policies along policy agreements, and you keep a clear record of your work in a claims system that you will be trained in. You’ll accomplish this by ensuring timely and accurate documentation is completed as you work on each claim.    Qualifications:  - 2 years' previous experience as an outside adjuster is highly desired.  - Previous experience as an outside adjuster is highly desired.  - Proficiency in using Xactimate and other relevant software for estimating.  - Strong critical thinking and technical skills to assess damages accurately and expedite claims settlements.  - Excellent communication and interpersonal skills to provide exceptional customer service.  - Ability to travel to customers' homes and handle virtual claims countrywide effectively.  - Detail-oriented and organized, with a focus on delivering high-quality work.  - This position is not available for California, Alaska, Hawaii or Puerto Rico residents.    Required Qualifications:  - Residency within the posted location is mandatory for this role.   - Are willing and able to carry a 50-pound ladder and access up to a 6/12 pitch on a one to two-story roof. - Valid driver's license and willingness to travel as part of the job requirements.    You’re provided with comprehensive training:  - The training program is designed to help you build a claims foundation and understand the systems and processes in your day-to-day work. - Ongoing training opportunities for continuous improvement happen regularly on the job. - You will be required to attend approximately 2 weeks of training that will take place in Dallas, TX.    Notice of Licensing Requirement:  - As a condition of employment, your office/area may require you to obtain an adjuster and/or an appraiser license which includes passing an additional background check with the Department of Labor. If applicable, you will be required to secure license(s) within 60 days of hire.  - If required, the Hiring Manager will work with you along with the Centralized Licensing team to ensure that you are properly licensed.    Sign On Bonus:   You may be eligible for a $1,000 Licensing Sign on Bonus if you have the applicable active licenses needed for this role.  This could include Home Resident Property & Casualty License, Designated Home State (DHS) Florida or Texas License, and/or applicable Appraiser License.  *Current employees or candidates who have previously worked for Allstate, including its family of companies, are not eligible for this sign-on bonus.   Company Car:  Based on our Company Car Guidelines, this role may qualify for a company car. Our leadership team determines this based on annual work mileage for this location. You may be required to use your personal vehicle until these guidelines are met. We offer mileage reimbursements for personal vehicle usage during work.    Allstate Benefits:  Being a part of Allstate means you receive a benefits package from Day 1 of employment.  This includes time off, healthcare, retirement, and more.  That is why as an Allstater, you’ll enjoy a Total Rewards package that includes:  - Competitive pay with needed support for continuous development and career advancement.  - Flexibility in scheduling and a time off policy that helps support your work/life balance.  - Initial and ongoing training to get you proficient in your new role.  - Comprehensive benefits like a 401K/pension, education reimbursement, and programs to help you balance work with the rest of your life. Visit www.allstategoodlife.com to learn more.    #LI-SV1 Skills Active Listening, Communication, Critical Thinking, Customer Service, Empathy, Multitasking, Time Management, Working Independently, Xactimate Compensation Compensation offered for this role is $68,000 - $115,245 and is based on experience and qualifications. The candidate(s) offered this position will be required to submit to a background investigation. The candidate(s) offered this position will be required to submit to a background investigation. Joining our team isn’t just a job — it’s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger – a winning team making a meaningful impact. Allstate generally does not sponsor individuals for employment-based visas for this position. Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component. For jobs in San Francisco, please click “here” for information regarding the San Francisco Fair Chance Ordinance. For jobs in Los Angeles, please click “here” for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance. To view the “EEO Know Your Rights” poster click “here”. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs. To view the FMLA poster, click “here”. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint. It is the Company’s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee’s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. • Negotiating settlement of claims within designated authority. • Communicating claim activity and processing with the claimant and the client. • Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

JOB DESCRIPTION Job Title Insurance Follow-up Specialist FLSA Non-Exempt Reports to Manager Grade D Location Remote Band 1A Summary/Objective Under limited supervision the Insurance Follow-up Specialist reviews and manages the billing and collections for hospitals and physicians. This type of specialist acts as an intermediary between the medical institution, patients, and the insurance agency. They assist in filing insurance claims, determining correct reimbursements/ adjustment/write-offs, and denial management. They also analyze plans to determine which benefits are covered, submit secondary insurance claims, generate patient statements, and follow-up on those submissions. Essential Job Functions - Work with insurance companies on behalf of hospitals and physician practices to resolve outstanding issues. - Analyze claims (denial/non-denial) in practice management systems, internal system and direct toward resolution (Payment, Adjustment & self-pay). - Technical billing and denial follow-up on all assigned payer claims - Call Payer (Insurance/ third parties) to resolve claims (denial/non-denial) after review from PMS, internal system & process toward resolution (Payment, Adjustment & self-pay). - Identify potential process improvements, trends, issues and escalate to Supervisor. - Be part of initial and all ongoing training session to enhance knowledge of RCM processes. - Resolve complex patient account issues requiring investigation of system timeline comments, payer reimbursements and account transactions. - Identify trends/payer issues and escalate complex payer issues to the lead billing specialist, as necessary. - Maintain a working knowledge of client policies and procedures. Follow the Workflow documentation like SOP’s Update tracker, Issue Log and Trend logs. - Maintain quality standards as determined by management. - Assist the Manager or Team Lead in working priority reports promptly, effectively, and efficiently. - Maintain accurate records within a collections database. - Be a mentor to new employees and assist in their training and development. - Performs other duties as directed. - Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance. Key Success Indicators/Attributes - Ability to prioritize and multi-task in a fast-paced, changing environment. - Demonstrate ability to work in all work types and specialties. - Demonstrate ability to self-motivate, set goals, and meet deadlines. - Demonstrate leadership, mentoring, and interpersonal skills. - Demonstrate excellent presentation, verbal and written communication skills. - Ability to develop and maintain relationships with key business partners by building personal credibility and trust. - Maintain courteous and professional working relationships with employees at all levels of the organization. - Work in accordance with corporate and organizational security policies and procedures, understand personal role in safeguarding corporate and client assets, and take appropriate action to prevent and report any compromises of security within scope of position. - Demonstrate excellent analytical, critical thinking and problem-solving skills. - Manage the Individual KRA’s as per the provided metrics. - Understand client requirements and specifications of the project & Ensure targeted collections are met on a daily / monthly basis. - Meet the productivity targets of clients within the stipulated time. Ensure timely follow up on pending claims and to prepare and Maintain individual status reports. - Skill in operating a personal computer and utilizing a variety of software applications is essential. - Knowledge of coding convention and rules established by the AHIMA, American Medical Association (AMA), the American Hospital Association (AHA) and the Center for Medicare and Medicaid (CMS), for assignment of diagnostic and surgical procedural codes is an added advantage. - Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation is an added advantage. Supervisory Responsibility No Work Environment This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and phones. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus. Position Type/Expected Hours of Work This is a full-time position. Schedule is M-F 8am-4pm EST without a lunch, with a lunch it is M-F 8am-430pm EST. This position occasionally requires long hours and weekend work. Travel Minimal travel required; up to 5% Required Education and Experience Knowledge of medical and insurance terminology such as CPT, ICD-9, ICD-10, HCPCS, co-pay, deductible or co-insurance, and full understanding of hospital/physician billing. Minimum 1-2 years’ experience in Medical Billing/Coding and experience with standard office software products. High School diploma or equivalent. Preferred Education and Experience N/A Additional Eligibility Qualifications N/A Security Access Requirements In addition to the specific security access required by the employee’s client engagement, the employee will have access to the Omega set forth in the “Omega Field Employee” profile. AAP/EEO Statement Omega is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned. Qualifications for Internal Candidates Same Posting Description for Internal and External Candidates Qualifications for Internal Candidates Same Posting Description for Internal and External Candidates