
Medical Claims Follow-up Specialist
14 hours ago
We are seeking a skilled Medical Claims Follow-up Specialist to join our team. As a Medical Claims Follow-up Specialist, you will be responsible for contacting insurance companies and patients to follow up on outstanding medical claims and ensure accurate reimbursement.
This process involves navigating complex billing and coding rules, and medical claims follow-up specialists often play a critical role in denial management.
- Denial Management
- Follow-up and Resolution:
- Follow up with insurance companies to inquire about the status of denied claims.
- Documentation:
- Maintain thorough records of all interactions and follow-up actions.
- Re-submittal:
- Involved in re-submitting claims with corrected information or appealing denials.
- Communication:
- Communicate with patients and internal stakeholders about denial statuses and resolution efforts.
- Billing and Coding Rules
- Navigate complex billing and coding rules to ensure accurate reimbursement.
The Importance of Denial Management
- Increased Revenue
- Effective denial management helps healthcare providers recover more revenue from claims.
- Reduced Turnaround Time
- Speeding up the revenue cycle through denial management can improve cash flow.
- Improved Patient Relationships
- Follow-up specialists communicate with patients to explain denial reasons and ensure they understand the process.
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