Remote Insurance Follow-Up Representative- Physician

Join a USA Today Top 100 Workplace & Best in KLAS Team! Remote Insurance Follow-Up Representative- Physician Pay Range: 58-60K+ Annually | Schedule: Monday–Friday, 8am–5pm EST | Location: Fully Remote Work Where Excellence is Recognized At RSi, we've proudly served healthcare providers for over 20 years, earning recognition as a "Best in KLAS" revenue cycle management firm and a USA Today Top 100 Workplace. Our reputation is built on delivering exceptional financial results for healthcare providers—and an unbeatable work culture for our team. We seek high-performing individuals willing to join our sharp, committed, and enthusiastic team. Here, your performance is valued, your growth is prioritized, and your contributions make a meaningful impact every day. Your Role: Essential, Rewarding, Impactful As a Remote Medical Insurance Follow-Up Representative – Physician Billing, you'll play a critical role in managing outstanding accounts receivable by pursuing timely and accurate payment from insurance carriers and/or patients. The role involves investigating unpaid claims, resolving denials, and maintaining detailed documentation to reduce aged accounts and improve cash flow for healthcare organization. Your diligence in resolving claims directly supports providers', overall financial health, creating a ripple effect of positive outcomes. What You'll Do:

• Perform follow-up on outstanding insurance and patient balances using payer portals, phone calls, and correspondences.
• Analyze denials to uncover trends and root causes and recommend process improvements.
• Monitor assigned worklists or aging reports to ensure timely follow-up on all accounts.
• Investigate and follow up on unpaid or denied claims to ensure timely reimbursement.
• Review insurance remittance advice (EOBs/ERAs) to determine action needed on denied or underpaid claims.
• Initiate reconsiderations and resubmissions as necessary.
• Submit appeals and corrected claims with appropriate documentation based on payer specific guidelines in compliance with payer deadlines.
• Follow Up and Review
• Communicate with insurance payers to resolve claim issues such as medical necessity, authorization, bundling, and eligibility rejections.
• Contact patients to verify or obtain insurance information as needed.
• Identify underpaid claims based on contract expectations.
• Research and dispute underpayments with payers, collaborating with contract management as needed.
• Accurately document all actions taken within the appropriate workflow management system.
• Utilize internal resources including crosswalks, tip sheets, and team chats.
• Escalate unresolved issues appropriately to ensure timely resolution.
• Adhere to Productivity and Quality Standards
• Support the onboarding of new team members with payer and system specific training.
• Ability to work independently and as part of a team in a fast-paced environment
• Collaborate closely with coding, patient access, billing, compliance, and internal teams to resolve root causes of denials.
• Work within CMS, Medicaid, and commercial payer guidelines to ensure compliance
• Support your teammates in achieving collective goals, ensuring our clients' continued success.
• Recommend process improvements based on denial trends and payer behavior.
• Strong and effective verbal and written communication and analytical skills
• Perform other related duties as assigned.

What We're Looking For:

• Minimum 3+ years of experience in medical billing or insurance follow-up, preferably in a healthcare or hospital setting
• Strong understanding of insurance payers, claim life cycles, and denial management.
• Proficiency with CMS-1500, CPT, HCPCS, ICD-10, EOB’s and payer-specific policies
• Rural Health Clinic experience preferred.
• Experience in utilizing software such as: Epic, Cerner, Meditech, SSI, IDX/Centricity, Athena, Keane, etc.
• Strong organizational and communication skills, with the ability to independently manage multiple tasks.
• High school diploma or equivalent required; associate degree preferred.
• Preferred Certifications: Certified Revenue Cycle Representative (CRCR)-HFMA, Certified Professional Biller (CPB)-AAPC, Certified Medical Reimbursement Specialist (CMRS)-AMBA
• Understanding of and adherence to HIPAA and other regulatory compliance requirements.

Why You'll Love RSi:

• Competitive pay with ample opportunities for professional growth.
• Fully remote position with a stable Monday–Friday schedule.
• Collaborative, performance-driven environment with expert leadership.
• Mission-driven work supporting essential healthcare services.
• Recognition as a nationally respected leader in healthcare revenue management.

Physical Requirements:

• Comfortable working at a computer for extended periods.
• Ability to occasionally lift items weighing up to 15 pounds.

What to Expect When You Apply: Our hiring process is designed to find exceptional candidates. Once your application is received, you'll receive an invitation to complete an initial skills assessment. This step is essential: completing this assessment promptly positions you for an interview and demonstrates your commitment to excellence. We believe in creating exceptional teams, and this process ensures that every member at RSi has the opportunity to thrive and grow. Ready to be part of something special? Apply now and join our team! Apply tot his job Apply To this Job