Insurance Follow-Up Specialist

Job Description

Job Description

We are seeking a diligent Insurance Follow-Up Specialist to join our team in Springfield, Massachusetts. As an Insurance Follow-Up Specialist, you will be handling various responsibilities related to claim reviews and provider appeals. Your role will also include addressing business problems and issues that emerge during the course of an appeal review. We offer a short term contract employment opportunity in this role.

Responsibilities :

• Conducting comprehensive reviews of post claim review provider appeals in a timely manner.
• Providing advice and support to Provider Relations Representatives on complex issues.
• Identifying and addressing business challenges and problems that arise during an appeal review.
• Collaborating with other departments to implement changes to policies.
• Proposing and suggesting training opportunities for other departments on the provider appeals process.
• Processing and managing customer credit applications with accuracy and efficiency.
• Maintaining accurate and up-to-date customer credit records.
• Monitoring customer accounts and taking necessary action as required.
• Resolving customer inquiries in a timely and detail oriented manner.
• Proficient in Appeals and Claim Administration
• Prior experience in a similar role within the insurance industry
• Excellent communication skills, both written and verbal
• Ability to handle multiple tasks and prioritize workload effectively
• Strong attention to detail and the ability to work accurately under pressure
• Proficiency in using computer systems and software related to job duties
• Solid understanding of insurance policies, procedures, and regulations
• Ability to work collaboratively as part of a team
• High level of integrity and discretion in handling confidential information
• Excellent problem-solving skills, with the ability to think strategically and act tactically
• Ability to understand and interpret complex insurance claims and appeals
• Proven track record of following up on insurance claims and appeals in a timely manner
• Demonstrated ability to handle difficult customer situations with patience and professionalism.