Insurance Follow-Up Agent

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    "requisitionDescription": "<div><div><p data-pasted=\"true\"><strong><u>JOB SUMMARY:&nbsp;</u></strong></p><p>FMS, Inc. is seeking a proactive and detail-oriented <strong>Medical Insurance Follow-Up Agent</strong> to join our Revenue Cycle team. In this role, you will be responsible for ensuring timely and accurate follow-up on medical insurance claims. Your primary goal is to identify and resolve issues that prevent reimbursement, while maintaining compliance with all payer and regulatory guidelines.</p><p><strong><u>JOB DUTIES AND RESPONSIBILITIES:</u></strong></p><ul style=\"list-style-type: disc;margin-left: -0.25in;\"><li>Conduct timely follow-up on outstanding insurance claims via phone, online portals, or written correspondence.</li><li>Investigate and resolve denied, delayed, or underpaid claims by communicating with insurance companies and third-party payers.</li><li>Review Explanation of Benefits (EOBs) and remittance advice to ensure proper claim adjudication.</li><li>Identify trends in denials or payment delays and escalate issues as necessary.</li><li>Document all claim activity and communications accurately in the billing system.</li><li>Verify insurance coverage and eligibility when required for follow-up activities.</li><li>Collaborate with billing, coding, and patient services teams to resolve discrepancies.</li><li>Maintain compliance with HIPAA and other applicable laws and guidelines related to medical billing and patient privacy.</li><li>Meet department productivity and quality standards.</li></ul><p><strong><u>JOB QUALIFICATIONS:</u></strong></p><ul style=\"list-style-type: disc;margin-left: -0.25in;\"><li>Education:<ul style=\"list-style-type: circle;\"><li>High school diploma or equivalent required.</li><li>Associate degree or coursework in healthcare administration, billing, or a related field preferred.</li></ul></li><li>Experience:<ul style=\"list-style-type: circle;\"><li>1+ year of experience in medical billing, insurance follow-up, or healthcare collections required.</li><li>Familiarity with commercial, Medicare, and Medicaid insurance plans strongly preferred.</li></ul></li><li>Skills &amp; Competencies:<ul style=\"list-style-type: circle;\"><li>Strong knowledge of EOBs, claim denials, appeals, and reimbursement processes.</li><li>Excellent verbal and written communication skills.</li><li>Strong organizational and time management skills.</li><li>Proficiency in medical billing software and Microsoft Office (Excel, Outlook, Word).</li><li>Ability to work independently and as part of a team.</li><li>High attention to detail and accuracy.</li><li>Proficient typist with ability to operate and navigate multiple computer systems with ease.</li></ul></li></ul><p data-pasted=\"true\"><strong><u>WORK-FROM-HOME REQUIREMENTS:</u></strong></p><ul style=\"list-style-type: disc;margin-left: -0.25in;\"><li>Reliable high-speed internet and secure, quiet workspace</li><li>Employee-provided WFH equipment</li></ul><ul type=\"disc\"><ul type=\"circle\"><li>Desktop &amp; Dual Monitors - 4vCPU with minimum 1.6 GHz or faster processor. For higher video/screen share resolution and frame rate, a four-core processor or better is required</li><li>RAM: 8000 MB</li><li>Hard Drive: 6 GB or more</li><li>.NET Framework version 4.6.1 or later</li><li>Windows 10/11</li><li>Mouse</li><li>Headset</li><li>Webcam</li></ul></ul><ul style=\"list-style-type: disc;margin-left: -0.25in;\"><li>Comfortable using video conferencing tools throughout each scheduled shift</li><li>Ability to maintain confidentiality and protect patient health information (PHI) in a remote environment</li></ul></div></div>\n",
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