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Insurance Follow Up Specialist
Mindful Support Services. Independently work outstanding insurance A/R, focusing on denied, rejected, and aged claims, including balances aged 120+ days.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical insurance accounts receivable follow-up and claim resolution, with a strong focus on denied and aged claims. Proficient in navigating payer portals and maintaining accurate documentation in EHR systems.
Highest-signal resume keywords
Medical Insurance A/R Follow-UpClaim Resolution ExperienceEHR Experience (AdvancedMD)Payer Portal NavigationStrong Communication Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claim AnalysisDenial Reason Code AnalysisClaims SubmissionPayment PostingDocumentation Maintenance
Soft Skills
Attention to DetailOrganizational SkillsFollow-ThroughProfessional Communication
Tools & Technologies
EHR SystemsPayer PortalsClearinghouse ToolsMicrosoft ExcelMicrosoft Outlook
Industry Keywords
Commercial InsuranceMedicareMedicaidBehavioral Health BillingManaged Medicaid Claims
Tech Stack
Tools & technologiesMacOS
About the role
Key responsibilities & impact- Independently work outstanding insurance A/R, focusing on denied, rejected, and aged claims, including balances aged 120+ days.
- Analyze denial reason codes, payer correspondence, eligibility and benefits information, authorization requirements, coding or claim-edit issues, and filing-limit concerns to determine the appropriate next action.
- Submit and track corrected claims, reprocessed claims, reconsiderations, appeals, medical-record submissions, and other payer-required documentation.
- Navigate commercial payer portals and communicate directly with payer representatives to obtain claim status, denial details, payment information, and resolution commitments.
- Communicate claim status, documentation needs, and action items to providers and internal partners.
- Post insurance payments and adjustments accurately when assigned, ensuring payment activity aligns with remittance advice and claim-resolution outcomes.
- Maintain thorough, actionable documentation in the EHR (AdvancedMD) and related tracking tools so team members can understand claim history and next steps.
Requirements
What you’ll need- At least 2 years of direct medical insurance A/R follow-up and claim-resolution experience in a healthcare billing environment.
- Hands-on experience working commercial insurance, Medicare, Medicaid, and managed Medicaid claims.
- Strong written and verbal communication skills, with the ability to communicate professionally and effectively with payer representatives, providers, managers, and internal teams.
- Experience working in an EHR or practice-management system, payer portals, clearinghouse tools, Microsoft Excel, and Outlook.
- Strong attention to detail, organization, follow-through, and documentation habits.
- Background check required.
- Behavioral health billing and insurance A/R experience preferred.
- Experience with AdvancedMD or a similar behavioral health EHR/practice-management platform preferred.
- Experience with payer portals for regional and national commercial payers, including Blue Cross Blue Shield plans, Aetna, Cigna, Optum/UnitedHealthcare, Medicare contractors, and Medicaid managed-care organizations preferred.
- Experience working with Apple computers and macOS preferred.
Benefits
Comp & perks- 75% coverage of health, dental, and vision insurance
- 15 PTO days accrued annually in first year
- 6 paid holidays per year
- 401k matching
- Life Insurance
- Professional development training and opportunities for advancement