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Insurance Follow-up Representative

Tech Observer
Menomonee Falls, WI Full Time | Contractor
POSTED ON 4/6/2025
AVAILABLE BEFORE 8/4/2025

Title: Insurance Follow-up Representative

Duration: 3 months

Location: Menomonee Falls, WI

Duties:

  • Responsible for researching and resolving all unpaid insurance claims and following up on all customer inquiries/complaints related to unpaid balances.
  • Answers patient calls and researches and responds to patient concerns within 24 working hours.
  • Maintains knowledge of complex reimbursement methodologies in Managed Care contracts including DRG, per diem, per visit, fee schedule and surgical group methodologies.
  • Applies knowledge for accurate resolution of claims within contract terms.
  • Uses knowledge of hospital policy, department procedures, Wisconsin Uniform Billing Regulations (UB04 Mannual), HMO/PPO agreements and other contractual arrangements to maintain accounts receivable, manage commercial payors, and manage appeals.
  • Serves as back-up to person primary on taking incoming calls. Monitors que light to ensure minimal wait times for patients in call que.
  • Identifies denial trends and reports issues to Insurance Follow-up Coordinator/Insurance Follow-up Supervisor for escalation with payer liaisons
  • Participates in cross-training efforts for specific systems based on goals set by the PFS department.
  • Addresses accounts qualifying to workstation within one week utilizing system specific follow up procedures.
  • Coordinates efforts with ancillary departments as needed in a timely manner for effective resolution.
  • Updates new insurance information received on an account to reflect accurate insurance plan coding to ensure accurate statements are mailed to patients.
  • Uses transaction codes specific to each system and links those to UB 1500 bills and agreements to process follow-up functions.
  • Updates and verifies payor specific account information.
  • Two years of business office experience in billing, customer service, or collections in a healthcare environment is required.

Job Types: Full-time, Contract

Pay: $24.00 - $27.00 per hour

Benefits:

  • 401(k)
  • Dental insurance
  • Health insurance
  • Vision insurance

Schedule:

  • 8 hour shift
  • Monday to Friday

Education:

  • High school or equivalent (Required)

Experience:

  • Medical billing: 2 years (Required)
  • Insurance follow-up: 2 years (Required)
  • Healthcare: 2 years (Required)

Work Location: In person

Salary : $24 - $27

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