National Jewish Health is seeking an experienced Medical Billing & Follow-Up Specialist to support the resolution of unpaid and denied insurance claims.
This role is responsible for contacting insurance carriers to verify claim status, resolve payment delays, and ensure accurate reimbursement. The ideal candidate has prior experience working in a medical setting and a solid understanding of insurance billing, claim follow-up, and payer-specific requirements.
Responsible for financial resolution of receivables by verifying appropriate reimbursement for services rendered through collection techniques, problem solving, claims follow-up, and use of patient accounting and payer software.
Key responsibilities
- Contact insurance companies daily via phone and payer portals to follow up on unpaid or denied claims and resolve reimbursement issues.
- Request, submit, and review missing or corrected claim and patient information to support timely payment.
- Review CPT and ICD-10 codes to ensure claims meet payer requirements and draft and submit appeals when necessary.
- Investigate payment delays and incorrect payments while maintaining detailed documentation in the patient accounting system.
- Communicate with patients, providers, and insurance representatives with strong attention to detail and clear written and verbal communication.
- Respond to incoming patient billing inquiries and resolve concerns in a professional and timely manner.
- Perform account audits, work follow-up collections, and process refunds, payment transfers, and adjustments as needed.
- High school diploma or equivalent required; some college coursework preferred.
- Minimum of 2 years of recent and related healthcare experience required.
- At least 2 years of experience in hospital billing, collections, follow-up, accounting, and customer service preferred.
- Strong understanding of CPT, HCPCS, ICD-10, HCFA, UB04, DRG, insurance benefits, authorizations, and referrals.
- Ability to read and interpret EOBs, ERAs, claim adjudication vouchers, and payer documents.
- Experience with appeals, claim follow-up, re-bills, secondary billing, and reimbursement resolution.
- Strong negotiation, problem-solving, mathematical, and communication skills.
- Computer proficiency and attention to detail required.
- Comprehensive medical coverage, including multiple Cigna health plans for Colorado, regional office, and remote employees.
- Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).
- Generous paid time off and six paid holidays.
- Dental and vision coverage effective the first of the month after hire.
- 403(b) retirement plan with employer contributions after two years.
- Wellness incentives up to $200 annually.
- Tuition reimbursement up to $5,250 annually.
- Child care assistance through a childcare FSA with employer contribution.
- Public Service Loan Forgiveness (PSLF) eligible employer.
- Employer-paid disability and life insurance.
- Optional voluntary benefits including accident, hospital indemnity, and legal plan coverage.
- Local service discounts and RTD bus pass savings.
Location
Glendale, Colorado, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
4 weeks ago