What are the responsibilities and job description for the Insurance Claims Processor position at LaSalle Network?
Job Description
The Insurance Follow-Up Specialist role at LaSalle Network is a critical position in managing the claims process, resolving outstanding accounts, and ensuring optimal reimbursement from insurance payers.
This individual will be responsible for proactively managing insurance claims, investigating and resolving denied, delayed, or underpaid claims, verifying insurance eligibility and coverage details using Epic EMR, and communicating with insurance companies, patients, and internal stakeholders regarding claim statuses and outstanding balances.
In addition to these duties, the Insurance Follow-Up Specialist will also maintain strict compliance with HIPAA, federal/state regulations, and payer-specific guidelines, as well as generate and analyze reports to identify trends, bottlenecks, and process improvement opportunities.
Responsibilities
- Manage insurance claims, ensuring accurate and timely billing, follow-up, and resolution.
- Investigate and resolve denied, delayed, or underpaid claims, working directly with insurance providers.
- Verify insurance eligibility and coverage details using Epic EMR, ensuring accurate claim submissions.
- Identify and appeal claim rejections and denials, collaborating with internal teams to address discrepancies.
- Process payment postings, adjustments, and reconciliations to maintain account accuracy.
- Communicate with insurance companies, patients, and internal stakeholders regarding claim statuses and outstanding balances.
