Role Description FMS, Inc. is seeking a proactive and detail-oriented Medical Insurance Follow-Up Agent to join our Revenue Cycle team. In this role, you will be responsible for ensuring timely and accurate follow-up on medical insurance claims. Your primary goal is to identify and resolve issues that prevent reimbursement, while maintaining compliance with all payer and regulatory guidelines. - Conduct timely follow-up on outstanding insurance claims via phone, online portals, or written correspondence. - Investigate and resolve denied, delayed, or underpaid claims by communicating with insurance companies and third-party payers. - Review Explanation of Benefits (EOBs) and remittance advice to ensure proper claim adjudication. - Identify trends in denials or payment delays and escalate issues as necessary. - Document all claim activity and communications accurately in the billing system. - Verify insurance coverage and eligibility when required for follow-up activities. - Collaborate with billing, coding, and patient services teams to resolve discrepancies. - Maintain compliance with HIPAA and other applicable laws and guidelines related to medical billing and patient privacy. - Meet department productivity and quality standards. Qualifications - High school diploma or equivalent required. - Associate degree or coursework in healthcare administration, billing, or a related field preferred. - 1+ year of experience in medical billing, insurance follow-up, or healthcare collections required. - Familiarity with commercial, Medicare, and Medicaid insurance plans strongly preferred. - Strong knowledge of EOBs, claim denials, appeals, and reimbursement processes. - Excellent verbal and written communication skills. - Strong organizational and time management skills. - Proficiency in medical billing software and Microsoft Office (Excel, Outlook, Word). - Ability to work independently and as part of a team. - High attention to detail and accuracy. - Proficient typist with ability to operate and navigate multiple computer systems with ease. Requirements - Reliable high-speed internet and secure, quiet workspace. - Employee-provided WFH equipment. - Desktop & Dual Monitors - 4vCPU with minimum 1.6 GHz or faster processor. For higher video/screen share resolution and frame rate, a four-core processor or better is required. - RAM: 8000 MB. - Hard Drive: 6 GB or more. - .NET Framework version 4.6.1 or later. - Windows 10/11. - Mouse. - Headset. - Webcam. - Comfortable using video conferencing tools throughout each scheduled shift. - Ability to maintain confidentiality and protect patient health information (PHI) in a remote environment.

• Take inbound calls from interested Medicare beneficiaries • Educate clients on Medicare Advantage, Supplement, and Part D plans • Guide clients through enrollment via CRM and telephonic platforms • Achieve personal sales goals with uncapped commission potential • Maintain compliance with CMS regulations and training standards

• Take inbound calls from interested Medicare beneficiaries • Educate clients on Medicare Advantage, Supplement, and Part D plans • Guide clients through enrollment via CRM and telephonic platforms • Achieve personal sales goals with uncapped commission potential • Maintain compliance with CMS regulations and training standards

• Identify client needs and recommend tailored insurance solutions • Develop and maintain strong client relationships • Generate leads through networking, referrals, and company-provided resources • Educate clients on available policies and coverage options • Follow up with prospects to close sales and maintain customer satisfaction • Stay informed about industry trends and product offerings • Work independently while collaborating with a supportive team