Insurance Follow-Up Representative
Arizona Residents Only | Full-Time | Monday–Friday
Flexible schedule between 6:00 AM – 5:00 PM (Core hours: 8:30 AM – 2:30 PM)
Position Summary
We are seeking an experienced Insurance Follow-Up Representative to support revenue cycle operations by managing outstanding insurance accounts and ensuring timely, accurate reimbursement. This role is responsible for resolving unpaid or underpaid claims, submitting appeals, researching payer discrepancies, and maintaining compliance with federal and state billing regulations. The ideal candidate has strong AHCCCS and Medicare experience, advanced UB04 billing knowledge, and a proactive approach to claim resolution.
Key Responsibilities
- Performed account follow-up on outstanding insurance balances and took appropriate action to resolve claims in accordance with federal and state regulations
- Contacted assigned accounts daily and completed timely collection follow-up activities on unpaid or underpaid claims
- Submitted, tracked, and managed claim appeals to ensure proper reimbursement
- Investigated denied claims and resolved billing discrepancies with insurance carriers
- Maintained accounts receivable days within established departmental goals
- Communicated with insurance companies, healthcare providers, employers, and patients/families to obtain accurate information and maximize reimbursement
- Verified charge accuracy and corrected account errors through phone and written communication
- Monitored contractual, billing, registration, and posting errors and provided ongoing feedback to leadership
- Reviewed EOBs, patient insurance information, and managed care plan details to verify applicable contracts and member eligibility
- Researched CPT and Revenue (REV) codes to support claim accuracy and reimbursement
- Documented all collection activity, account updates, and payer communication thoroughly within the collection system
- Worked managed care and government payer accounts efficiently and accurately
- Maintained professional and effective customer service while collaborating with internal and external stakeholders
Required Qualifications
- Experience with Arizona Medicaid (AHCCCS) and Medicare claims
- Strong knowledge of UB04 billing forms
- Experience handling appeals, denials, and EOB review
- Knowledge of CPT and Revenue (REV) code research
- Ability to work independently in a fast-paced revenue cycle environment
- Strong written and verbal communication skills
- Must currently reside in Arizona
Preferred Qualifications
- Experience with revenue cycle or EMR platforms such as FinThrive, Quantum, or PFM (Allscripts)
- Strong documentation skills supporting escalated claims or legal/hearing-level appeals
- Previous experience in hospital or healthcare revenue cycle operations
Schedule
- Monday–Friday
- Flexible schedule between 6:00 AM – 5:00 PM
- Required core hours: 8:30 AM – 2:30 PM
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
