Specialist, Insurance Follow Up

About Revology

Revology is a technology-enabled healthcare revenue cycle management (RCM) firm providing outsourced services to hospitals, health systems, and physician groups. Our tech smart-from-the-start strategy enables us to break through conventional barriers and empower each Revologist to drive a higher standard of revenue cycle performance. This is possible because we spend our lives in the sweet spot where smart tech and good humans reach their highest potential and maximize outcomes.

At Revology, we are committed to stewarding and empowering an inclusive environment within our company and our communities. While we believe in “culture” - we don’t believe in “culture fit”. We encourage every single Revologist to bring their unique perspective, lived experience and authentic selves to the table. revology is an equal opportunity employer and we encourage everyone to apply for our available positions - including women, people of color, individuals with disabilities and those in the LGBTQIA+ community.

Role: Specialist, Insurance Follow-Up

Location: Remote. Must work in a location within the United States.

Travel: No travel required

Classification: Hourly, Non-Exempt

Reports to: Supervisor, Revenue Cycle Services

Salary Range: Commensurate with experience

About The Role

The Insurance Follow-Up (IFU) Specialist role is responsible for following up on outstanding accounts receivables and resolving payer denials to ensure accurate and timely reimbursement for our clients. An effective Specialist will be a creative problem-solver with a critical eye for details and an attitude of service. What makes this role at Revology different from other positions? These Revologists will also have the unique opportunity to provide feedback on the build of Revology products and solutions to enhance the end user experience.

Responsibilities

• Conduct timely and thorough follow-up with insurance payers via phone, portal, or written correspondence to determine claim status and resolve barriers to account resolution.
• Identify root causes of unpaid claims and take corrective action, including claim corrections, resubmissions, appeals, credit resolution or payment posting issues.
• Escalate systematic or high-impact denial trends to leadership and collaborate with internal teams to prevent reoccurrence as requested.
• Communicate barriers and opportunities to improve collections and reduce denials to leadership.
• Review and respond to insurance correspondence as needed to ensure complete and accurate reimbursement.
• Compose highly-detailed correspondence such as appeal forms, claim forms and other client- and/or patient-facing correspondence.
• Engage with patients and/or guarantors as needed to provide guidance on proper resolution of insurance claim balances. Demonstrate service mindset in all interactions.
• Document all actions and correspondence in Revology and/or client systems in accordance with internal policies and procedures.
• Maintain strong working knowledge of payer rules and regulations applicable to assigned work.
• Provide input and feedback on Revology products and solutions through early adoption of use to enhance the end user experience.
• Consistently meet or exceed established productivity and quality standards.
• Navigate several computer applications simultaneously; document all actions taken in appropriate Revology and/or client systems.
• Comply with and hold with utmost regard all compliance requirements to protect patient privacy and confidentiality.
• Stay curious, kind and contribute positively to the Revology culture. The health + harmony of the team is everybody’s responsibility at Revology.
  
  

The statements stated in this job description reflect the general duties as necessary to describe the basic function, essential job duties/responsibilities, job requirements, physical requirements and working conditions typically required, and should not be considered an all-inclusive listing of the job. Individuals may perform other duties as assigned, including work in other functional areas to cover absences or relief, to equalize peak work periods or otherwise balance the workload.

Requirements

• 3+ years of healthcare billing and insurance experience required.
• Knowledge of and/or experience with EOBs, ERAs, denial codes, CPT & ICD-10 codes, authorizations/referrals highly preferred.
• Ability to work independently to accomplish goals in a dynamic environment.
• High school diploma or equivalent required; bachelor’s degree or equivalent experience preferred.
• An aptitude for problem-solving, patience and flexibility while working in the complex industry of healthcare revenue cycle.
• Ability to comfortably navigate a technology-focused setup to efficiently complete assigned work (multiple monitors + several applications open simultaneously).
  
  

Remote Work Requirements

Internet capability must be a high-speed internet connection of 40 Mbps speeds or greater.

Physical Requirements

Must be able to perform physical activities, such as, but not limited to: moving or handling (lifting, pushing, pulling and reaching overhead) office equipment and supplies weighing 1 to 25 lbs. unassisted. Frequently required to sit for extended periods during the workday. Manual dexterity and visual acuity required. Must be able to communicate effectively on the telephone and in person.

Working conditions

Work will generally be performed indoors in an office environment. Must maintain a professional appearance and manner.

Employment eligibility

Candidates must be legally authorized to work in the United States without sponsorship.