Insurance Follow Up Representative – REMOTE Position Available In Sarasota, Florida

Description 1. Manages workflow for Humana PPI Audits, RAC Audits, or outpatient appeals and communicates daily with Sr. Director/Manager on trends identified 2. Respond to queries within 72 hours, appropriately documents in Cerner/ClaimIQ/Artiva and tracks all activity in the appeal tracker 3. Manages PDFU to assure timely follow up of accounts to effectively move through the revenue cycle 4. Completes claim appeals and assists with other projects as needed 5. Submits requests for medical records, ub’s, and itemized bills as needed 6. Responsible for being aware of the current department policies and procedures 7. Meet or exceed quality and quantity benchmark targets as established by management 8. Ability to perform all other duties as assigned or requested 9. Ensure confidentiality of all patient accounts by following HIPPA guidelines Candidates need to be able to research other insurance patients may have, understand process for coding/codes to be reviewed, and more denial related duties i.e. checking payer website for clarification on denial and doing research for that information.