CommonSpirit Medical Group (Mountain Management Services) is a leading provider of comprehensive office management services and affiliated physicians in Southeast Tennessee and North Georgia. Our award-winning, faith-based organization is dedicated to supporting the delivery of exceptional healthcare in the region. We are proud to be consistently recognized for excellence by organizations like U.S. News & World Report, PINC AI™, CMS, Healthgrades®, Leapfrog, and as one of the Best Places to Work in Tennessee. We are honored to be your trusted ally in health, dedicated to serving our community with compassion and excellence.
Insurance Follow Up Rep
Location
United States
Posted
53 days ago
Salary
$16 - $23 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Insurance Follow Up Rep
Mountain Management Services
Role Description As an Insurance Follow Up Rep, you will resolve unpaid insurance claims and collect outstanding balances from third-party payers. Every day you will: - Review denials - Initiate follow-up with insurers - Rectify billing errors - Submit appeals - Negotiate for maximum reimbursement To be successful, you will understand billing regulations, possess strong problem-solving skills, and communicate effectively to optimize revenue recovery. - Follow up with insurance payers to research and resolve unpaid insurance accounts receivable; make necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers. - Apply a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. - Communicate effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. - Resubmit claims with necessary information when requested through paper or electronic methods. - Anticipate potential areas of concern within the follow-up function; identify issues/trends and conduct staff training to address and rectify. - Recognize when additional assistance is needed to resolve insurance balances and escalate appropriately and timely through defined communication and escalation channels. Qualifications - High School Graduate or High School GED - Graduation from a post-high school program in medical billing or other business-related field (preferred) - Two years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities (preferred) Company Description CommonSpirit Medical Group (Mountain Management Services) is a leading provider of comprehensive office management services and affiliated physicians in Southeast Tennessee and North Georgia. Our award-winning, faith-based organization is dedicated to supporting the delivery of exceptional healthcare in the region. We are proud to be consistently recognized for excellence by organizations like U.S. News & World Report, PINC AI™, CMS, Healthgrades®, Leapfrog, and as one of the Best Places to Work in Tennessee. We are honored to be your trusted ally in health, dedicated to serving our community with compassion and excellence.
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