<p>This role focuses on resolving denied and non-paid insurance claims to ensure timely and accurate reimbursement. The representative will work insurance A/R accounts, communicate directly with payers, submit technical and clinical appeals, and identify root causes of underpayments, denials, and payment delays. Success in this role requires strong problem-solving skills, critical thinking, and the ability to work within federal, state, and payer-specific regulations.</p><p><br></p><p>Responsibilities:</p><ul><li>Examine denied and non-paid insurance claims to determine discrepancies</li><li>Contact insurance payers to follow up on outstanding claims</li><li>File technical and clinical appeals</li><li>Resolve underpayments, denials, and payment variances</li><li>Identify causes of payment delays and communicate trends to management</li><li>Document all account activity accurately in host and tracking systems</li><li>Maintain compliance with federal, state, and payer-specific regulations</li><li>Meet established productivity and quality standards</li></ul><p><br></p>

<ul><li>High School Diploma or GED (required)</li><li><strong>1+ year of customer service experience</strong> in areas such as:</li><li>Billing and coding</li><li>Insurance claims</li><li>Medical terminology</li><li>Insurance follow-up</li><li><strong>1+ year of relevant medical collections experience</strong>, including:</li><li>Hospital or physician billing operations</li><li>A/R follow-up</li><li>Denials and appeals</li><li>Revenue cycle or compliance</li><li>Provider relations or professional billing</li></ul><p><br></p>

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