Pride Health is looking for a Insurance Follow-Up Specialist our client’s medical facility, which is in Menomonee Falls, WI 53051 this is a great role with a 3+ Month Contract with the possibility of extension depends on your performance and a great way to start working with a top-tier healthcare organization! It's 100% onsite
Job Title: Insurance Follow-Up Specialist
Location: Menomonee Falls, WI 53051
Duration: 3+weeks contract with possibility of extension depends on the manager
Pay rate: $20 to $25/hr on W2
Description Job Summary:
ues to ensure compliance.
Troubleshooting & Issue Resolution: Identify, analyze, and resolve complex security issues through collaboration with technical teams.
Documentation & Planning: Create detailed documentation and assist in budget planning, oversight, and the strategic planning of security infrastructure, technology standards, and risk practices.
Communication & Leadership: Communicate effectively with clients, vendors, and colleagues to translate complex technical solutions into non-technical requirements. Provide consultation to the CIO, CTO, CISO, and other leaders on security issues and strategies.
Strategic Security Operations: Lead and oversee security operations in areas like identity and access management, data loss prevention, cloud security, and network security.
Job Functions: Job Description:
We are looking for an experienced and detail-oriented Insurance Follow-Up Specialist to join our team. This role involves researching and resolving unpaid insurance claims, addressing customer inquiries, and ensuring timely follow-up with insurance payers. The ideal candidate will have experience in the healthcare industry, a strong understanding of insurance processes, and excellent customer service skills.
Key Responsibilities:
Research and resolve unpaid insurance claims and follow up on all customer inquiries/complaints related to unpaid balances.
Answer patient calls and resolve patient concerns within 24 working hours.
Maintain knowledge of complex reimbursement methodologies in Managed Care contracts, including DRG, per diem, per visit, fee schedule, and surgical group methodologies.
Ensure accurate resolution of claims within contract terms, using knowledge of hospital policies, department procedures, and contractual arrangements.
Serve as back-up for incoming calls, minimizing wait times for patients.
Identify denial trends and report issues to Insurance Follow-up Coordinator/Insurance Follow-up Supervisor for escalation with payer liaisons.
Participate in cross-training efforts and manage accounts qualifying for follow-up.
Coordinate efforts with ancillary departments for timely issue resolution.
Update insurance information on accounts to reflect accurate plan coding and ensure proper statements are mailed to patients.
Use system-specific transaction codes for follow-up functions.
Required Skills & Experience:
Minimum of 2 years of business office experience in billing, customer service, or collections in a healthcare environment.
Strong attention to detail and excellent communication skills.
Experience with insurance websites and insurance follow-up.
Preferred experience with Epic or other healthcare-related systems.
Preferred Skills & Experience:
Experience with customer service, claims, billing, and managed care.
Knowledge of coding, insurance, and retail sales.
Benefits
Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
Equal Opportunity Employer
As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.
