Description
We are seeking a skilled Insurance Follow-Up Specialist to join a growing Ambulatory Surgery Center affiliated with one of the largest Health Systems in New York. This role is focused on insurance follow-up, resolving denied claims, and managing appeals to ensure timely reimbursement—particularly from commercial payors.
Key Responsibilities:
- Conduct follow-up with insurance carriers to resolve denied or underpaid claims
- Submit and monitor appeals to commercial payors and government insurance programs
- Process claims for Medicare, Medicaid, commercial insurance, no-fault, and workers’ comp
- Post payments and adjustments while reconciling accounts receivable
- Verify patient insurance and ensure accurate use of CPT, HCPCS, and ICD-10 codes
- Respond to patient billing inquiries and arrange payment plans as needed
- Collaborate with the revenue cycle team to reduce denials and improve reimbursement
- Ensure compliance with HIPAA and payer-specific regulations
Qualifications:
- 2–3+ years of medical billing experience, with a focus on insurance follow-up and appeals
- Experience with commercial payors is essential
- Orthopedics, ASC, or pain management billing experience is a plus
- Familiarity with billing software and EMRs
- Strong attention to detail, communication, and problem-solving skills
Work Details:
- Schedule: 8:00 AM–4:30 PM or 8:30 AM–5:00 PM (half-hour lunch)
- Work Arrangement: Fully on-site initially for training, then moving to hybrid work model
We are an equal opportunity employer and comply with all applicable federal, state, and local fair employment practices laws. We strictly prohibit and do not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex, sexual orientation, gender (including gender identity and expression), marital or familial status, age, physical or mental disability, perceived disability, citizenship status, service in the uniformed services, genetic information, height, weight, or any other characteristic protected under applicable federal, state, or local law. Applications from members of minority groups and women are encouraged.
