Insurance Follow-Up Specialist

Insurance Follow-Up Specialist

A Healthcare company is looking for a highly organized Insurance Follow-Up Specialist to support healthcare reimbursement operations. This Insurance Follow-Up Specialist focuses on confirming coverage details, securing required approvals, and keeping documentation current so claims and patient services move forward without unnecessary delays. The Insurance Follow-Up Specialist brings strong knowledge of insurance workflows, clear communication skills, and the ability to manage multiple priorities in a fast-paced medical setting.

Key Responsibilities

• Confirm patient eligibility, plan benefits, and coverage limits before scheduled visits, treatments, or procedures.

• Secure prior authorizations and pre-service approvals from payers for ordered medical services.

• Audit account details to ensure insurance data is complete, accurate, and ready for billing activities.

• Communicate with patients, providers, and insurance representatives to clarify benefit information, authorization updates, and out-of-pocket obligations.

• Track outstanding, denied, or incomplete authorization requests and drive timely follow-up to reach resolution.

• Maintain precise records in electronic medical records and billing platforms to support accurate reimbursement.

• Investigate insurance-related issues that could interrupt care delivery or delay payment, and take steps to resolve them.

• Follow payer policies, organizational standards, and applicable regulations throughout verification and authorization work.

• Partner with administrative, billing, and clinical teams to strengthen patient access and revenue cycle performance.

• Benefits: Health, Dental, Vision, 401k, and Sick Time Off.

Qualifications

• Experience handling insurance follow-up, eligibility verification, and authorization activities in a healthcare setting.

• Working knowledge of preauthorization requirements, payer rules, and medical billing processes and EPIC.

• Ability to review patient accounts carefully and identify missing, incorrect, or conflicting insurance information.

• Strong verbal and written communication skills for interacting with patients, providers, and insurance carriers.

• Familiarity with patient accounting and medical collections concepts related to reimbursement workflows.

• Proficiency using electronic medical records and billing systems to document and track account activity.

• Strong organizational skills with the ability to manage deadlines and shifting priorities in a fast-paced environment.

• TalentMatch®

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