Insurance Follow Up Specialist - Goodyear, AZ

Responsibilities

• Independently work outstanding insurance A/R, with a focus on denied, rejected, and aged claims, including balances aged 120+ days.
• Analyze denial reason codes, payer correspondence, eligibility and benefits information, authorization requirements, coding or claim-edit issues, and filing-limit concerns to determine the appropriate next action.
• Submit and track corrected claims, reprocessed claims, reconsiderations, appeals, medical-record submissions, and other payer-required documentation.
• Navigate commercial payer portals and communicate directly with payer representatives to obtain claim status, denial details, payment information, and resolution commitments.
• Communicate claim status, documentation needs, and action items to providers and internal partners in a clear, professional, solutions-focused manner.
• Post insurance payments and adjustments accurately when assigned, including ensuring payment activity aligns with remittance advice and claim-resolution outcomes.
• Maintain thorough, actionable documentation in the EHR (AdvancedMD) and related tracking tools so other team members can easily understand the claim history and next steps.

Qualifications

• At least 2 years of direct medical insurance A/R follow-up and claim-resolution experience in a healthcare billing environment.
• Hands-on experience working commercial insurance, Medicare, Medicaid, and managed Medicaid claims.
• Strong written and verbal communication skills, with the ability to communicate professionally and effectively with payer representatives, providers, managers, and internal teams.
• Experience working in an EHR or practice-management system, payer portals, clearinghouse tools, Microsoft Excel, and Outlook.
• Strong attention to detail, organization, follow-through, and documentation habits.

Preferred Qualifications

• Behavioral health billing and insurance A/R experience.
• Experience with AdvancedMD or a similar behavioral health EHR/practice-management platform.
• Experience with payer portals for regional and national commercial payers, including Blue Cross Blue Shield plans, Aetna, Cigna, Optum/UnitedHealthcare, Medicare contractors, and Medicaid managed-care organizations.
• Experience working with Apple computers and macOS.