Professional Billing:

Insurance Follow-up Specialist Billing Team Tigard, Oregon Description SUMMARY At ZoomCare we are working hard to make healthcare easy. Our mission is to deliver innovative, high-quality, convenient healthcare when patients need it. We offer same-day, no-wait visits in urgent care, primary care, and specialty care and we're expanding from our roots in the Pacific Northwest to new markets. We hope you will to be part of our dedicated, fast-moving team of superstars! ZoomCare is seeking an Insurance Follow Up Specialist to join our team! The Follow-up Specialist is responsible for resolving outstanding insurance claims to maximize reimbursement and reduce accounts receivable days. This position focuses on identifying, researching, and rectifying claim denials and delays for professional services through effectivemunication with insurance payers and internal departments.

SCHEDULE AND TRAINING

Monday - Friday | 9:00am-5:30pm flex schedule. Candidates must reside in Oregon or Washington Depending on the position and associated requirements, t may be additional mandatory training requirements that are outside of your scheduled shift.

ESSENTIAL FUNCTIONS

Reasonable amodations may be made to enable individuals with disabilities to perform the essential functions. Represent our values: Awesome, Creative, Respectful, Team Players, Get it Done. Work unpaid and partially paid insurance claims to resolve outstanding balances and secure accurate reimbursement in accordance with payer guidelines. Research claim status by utilizing insurance portals, conducting phone outreach, and drafting written correspondence as needed. Analyze denied or underpaid claims to identify root causes, trends, and necessary corrective actions. Submit timely and well-documented appeals for denied claims in alignment with specific payer policies and appeal procedures. Resubmit corrected claims with updated coding, documentation, or demographic information to facilitate proper adjudication. Maintain thorough and accurate records of all claim follow-up activities within the billing or revenue cycle management system. Collaborate with coding teams, clinical documentation specialists, and provider offices to gather missing information or resolve claim discrepancies. Monitor aging accounts and prioritize claims based on timely filing limits and payer response windows. Identify systemic issues or process inefficiencies impacting claim resolution and escalate concerns to management with supporting documentation. Meet or exceed established productivity and quality benchmarks while adhering topliance and privacy standards. Other duties as assigned.

QUALIFICATIONS

High school diploma or equivalent required; associate's degree in healthcare administration, Business, or a related field preferred. 2+ years of experience in medical billing, with a focus on professional billing and accounts receivable follow-up. Solid understanding of CPT, HCPCS, and ICD-10 coding systems and their application in claim submission and reimbursement. Experience working with electronic billing systems and payer portals to manage claim status, denials, and appeals. Familiarity with insurance reimbursement methodologies, claim adjudication processes, and payer-specific requirements. Working knowledge of medical terminology and healthcare documentation. Strong analytical and problem-solving skills with the ability to identify issues, evaluate alternatives, and implement solutions. Excellent written and verbalmunication skills, with the ability to collaborate effectively across teams and with external contacts. High attention to detail and accuracy, with proven ability to manage multiple tasks and meet deadlines in a fast-paced environment.

COMPENSATION PACKAGE

Medical, Dental, Vision benefits 401K with employer match Paid Time Off, Paid Holidays, Paid Parental Leave, Sabbatical Program

Hourly Pay Rate:

$23 - $29/hr

Other Compensation:

May be eligible for otherpensation such as bonuses

WORKING CONDITIONS

Project timelines and work volume/deadlines may often require more than your scheduled hours per week or work outside of regular business hours toplete essential duties of this job. Ability to work at aputer/workstation for prolonged periods of time. Close and distance vision and ability to adjust focus. Seeing, hearing, speaking, and writing clearly to effectivelymunicate with others. Exposure to sensitive and confidential information. Occasional reaching and lifting of small objects and operating office equipment. On-site presence required a minimum of 3 days per week to support non-electronic processes. Remote work available for the remaining workdays. Must wear a mask as needed. ZoomCare ismitted to the safety and wellbeing of our employees and patients. Tfore, we require that patient-facing employees receive all required vaccinations, including, but not limited to, Hepatitis B., MMR, PPD, Varicella (Chickenpox), TD/TDAP, and all employees to receive

COVID-19

as a condition of employment. Medical and religious exemptions or reasonable amodations may .