Medical Billing & Follow-Up Specialist

National Jewish Health is seeking an experienced Medical Billing & Follow-Up Specialist to support the resolution of unpaid and denied insurance claims. This role is responsible for contacting insurance carriers to verify claim status, resolve payment delays, and ensure accurate reimbursement. The ideal candidate has prior experience working in a medical setting and a solid understanding of insurance billing, claim follow-up, and payer-specific requirements.

Key Responsibilities:

• Contact insurance companies daily via phone and payer portals to follow up on unpaid or denied claims and resolve reimbursement issues.
• Request, submit, and review missing or corrected claim and patient information to support timely payment.
• Review CPT and ICD-10 codes to ensure claims meet payer requirements and draft and submit appeals when necessary.
• Investigate payment delays and incorrect payments while maintaining detailed documentation in patient accounting system.
• Communicate effectively with patients, providers, and insurance representatives.
• Respond to patient billing inquiries, providing clear, accurate information and resolving concerns professionally and timely.

Additional responsibilities include performing account audits using claims editing software, processing refunds and adjustments, identifying self-pay and potential bad debt accounts for referral, and maintaining knowledge of regulatory and contractual requirements related to billing and reimbursement.

Minimum Qualifications:

• High school diploma or equivalent required; some college coursework preferred.
• Minimum two years of recent healthcare experience, preferably in hospital billing, collection, follow up, accounting, and customer service.

Schedule: Full Time, Day Shift, Monday - Friday, 8:00 am - 4:30 pm.