Job Description

The Insurance Follow-Up Representative supports the revenue cycle by ensuring timely and accurate insurance verification, authorization confirmation, and resolution of outstanding insurance-related issues prior to patient services. This role is responsible for reviewing account information, communicating with insurance carriers and physician offices, and verifying that all insurance follow-up requirements are completed to avoid payment delays or denials. The Insurance Follow-Up Representative ensures that patient accounts are accurate and ready for billing.

Essential Functions

• Reviews patient accounts to verify insurance coverage, confirm authorizations, and ensure all required insurance information is captured and accurate prior to scheduled services.
• Communicates with insurance carriers, physician offices, and third-party vendors to confirm or obtain prior authorizations, eligibility, and benefit coverage.
• Updates and maintains patient account records with accurate demographic and insurance details in the system.
• Identifies and resolves discrepancies or missing information that may impact timely reimbursement.
• Documents all follow-up activities, communications, and account updates in the electronic health record and billing systems.
• Refers self-pay patients to the Financial Counselor and provides an accurate face sheet and account details to facilitate financial assistance.
• Assists with pre-registration processes by ensuring all required documentation is complete and forwarded to the appropriate departments.
• Collaborates with scheduling, registration, medical records, and billing teams to correct and validate information as needed.
• Provides reports or scheduling data to internal departments upon request.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• 0-2 years of registration/clerical experience in a hospital or other healthcare environment required

Knowledge, Skills and Abilities

• Knowledge of insurance verification, benefits coordination, and prior authorization processes.
• Strong attention to detail and data accuracy.
• Excellent communication and customer service skills.
• Ability to interpret and explain insurance policies and hospital payment procedures.
• Proficient in healthcare software systems and Microsoft Office applications.
• Ability to manage multiple tasks and prioritize work in a fast-paced environment.
• Strong problem-solving and organizational skills.