Insurance Follow-Up Representative

Healthcare Outcomes Performance Co. (HOPCo)

. Review insurance denials to determine and take the next appropriate action steps to receive payment from the payor .

Posted 9/17/2026full-timeRemote • Florida • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical claims processing, including the ability to analyze denials, appeal claims, and ensure timely reimbursement. Proficient in communication with payors and resolving discrepancies while maintaining accurate records.

Highest-signal resume keywords

Medical Claims Processing ExperienceClaims Denial AnalysisAppeal Claims ManagementCommunication With PayorsAdvanced Computer Knowledge

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims ProcessingDenial ManagementAppeals ProcessingAccounts Receivable ReductionClaim Discrepancy Resolution

Soft Skills

Effective CommunicationProblem Solving

Tools & Technologies

Windows-Based ProgramsMicrosoft WordMicrosoft Excel

Industry Keywords

Insurance DenialsExplanation of BenefitsBlue Cross/Blue ShieldCommercial InsuranceWorkman's Compensation

About the role

Key responsibilities & impact

Review insurance denials to determine and take the next appropriate action steps to receive payment from the payor
Appeal claims denied for no authorization, medical necessity, and other reasons
Verify receipt of claims with insurance plans to ensure timely reimbursement
Reduce insurance accounts receivable by working through outstanding accounts
Communicate with payors through phone calls, emails, and payor portals
Process and take action on written correspondence from insurance payors
Identify and trend reasons for claim denials
Resolve claim discrepancies reported by patients and other clinical departments

Requirements

What you’ll need

Must have a minimum of two years of medical claims processing experience
Must be able to read and understand the Explanation of Benefits and denial reasons
Advanced computer knowledge, including Windows-based programs such as Word and Excel
Experience working with Blue Cross/Blue Shield, Commercial insurance companies, and Workman's Compensation carriers

Benefits

Comp & perks

Competitive Health & Supplemental Benefits
Monthly stipend to use toward ancillary benefits
HSA with qualifying HDHP plans with company match
401k plan
Employee Assistance Program available 24/7
Employee Appreciation Days/Events
Paid Holidays & Paid Time Off