Insurance Follow Up Specialist

Columbia Orthopaedic Group

Every claim tells a story, and every resolved claim helps patients and providers move forward. If you enjoy investigating complex issues, solving reimbursement challenges, and making an impact behind the scenes, this role offers the opportunity to put your expertise to work.

Why This Role Is Different

The Insurance Follow-Up Specialist is an advanced revenue cycle role focused on resolving complex insurance claims, denials, and reimbursement issues. Your work directly supports the financial health of the organization while ensuring claims are processed accurately and efficiently.

You'll work independently while partnering with coding, billing, and clinical teams to identify trends, resolve payer issues, and improve overall revenue cycle performance.

About the Role

The Insurance Follow-Up Specialist manages advanced claim follow-up activities, including denial resolution, appeals, payer communication, and reimbursement analysis. This role serves as a key resource for resolving high-level insurance issues while supporting compliance with payer guidelines and internal billing standards.

Success in this position requires strong analytical skills, attention to detail, and the ability to navigate complex payer requirements with confidence.

What You Will Do

• Investigate and resolve unpaid, denied, or underpaid insurance claims to support timely reimbursement
• Prepare, submit, and track appeals, corrected claims, and reconsiderations while meeting payer deadlines
• Analyze EOBs, remittance advice, claim history, and payer requirements to identify and resolve reimbursement issues
• Communicate with insurance carriers, coding teams, and internal departments to resolve claim discrepancies and improve claim outcomes
• Identify denial trends, recommend process improvements, and serve as a resource for complex insurance follow-up questions
• Maintain accurate documentation while ensuring compliance with HIPAA, payer requirements, and organizational standards

Who Thrives in This Role

• You enjoy analyzing complex problems and finding effective solutions
• You are highly organized and take pride in accuracy and attention to detail
• You communicate confidently with payers and internal teams to resolve challenging issues
• You work independently while contributing to the success of the overall revenue cycle team
• High school diploma or GED required
• Three to five (3-5) years of medical billing, insurance follow-up, or accounts receivable experience required
• Experience resolving complex insurance denials and submitting appeals required
• Orthopaedic billing experience, familiarity with payer portals, and knowledge of electronic claims systems preferred