Remote Insurance Follow-Up Representative- Hospital

Join a USA Today Top 100 Workplace & Best in KLAS Team!

Remote Insurance Follow-Up Representative- Hospital

Pay Range: 58-60K+ Annually | Schedule: Monday–Friday, 8am–5pm EST | Location: Fully Remote

Work Where Excellence is Recognized

At RSi, we've proudly served healthcare providers for over 20 years, earning recognition as a "Best in KLAS" revenue cycle management firm and a USA Today Top 100 Workplace. Our reputation is built on delivering exceptional financial results for healthcare providers—and an unbeatable work culture for our team. We seek high-performing individuals willing to join our sharp, committed, and enthusiastic team. Here, your performance is valued, your growth is prioritized, and your contributions make a meaningful impact every day.

Your Role: Essential, Rewarding, Impactful

As a Remote Medical Insurance Follow-Up Representative - Hospital, you'll play a critical role for timely and accurate follow-up on outstanding insurance claims to ensure maximum reimbursement. Your role focuses on resolving unpaid or denied claims through communication with payers, analyzing remittance advice, and identifying trends that affect claim resolution. Your diligence in resolving claims directly supports providers’ overall financial health and creates a ripple effect of positive outcomes.

What You'll Do

• Analyze denials to uncover trends and root causes and recommend process improvements.
• Contact third-party payers via phone, email, and payer portals to check claim status, resolve denials, and ensure timely payment
• Review and interpret EOBs/ERAs to determine appropriate action steps
• Appeal denied or underpaid claims in accordance with payer policies and hospital guidelines.
• Resubmit corrected claims, provide necessary documentation to resolve and Initiate reconsiderations and resubmissions as necessary.
• Prepare and submit formal appeals with appropriate documents in compliance with payer deadlines.
• Communicate with insurance payers to resolve claim rejections.
• Contact patients to verify or obtain insurance information as needed.
• Identify underpaid claims based on contract expectations.
• Research and dispute underpayments with payers, collaborating with contract management as needed.
• Accurately document all actions taken within the appropriate workflow management system.
• Utilize internal resources including crosswalks, tip sheets, and team chats.
• Escalate unresolved issues appropriately to ensure timely resolution.
• Adhere to Productivity and Quality Standards
• Support the onboarding of new team members with payer and system specific training.
• Monitor and maintain aging buckets to meet department KPIs for follow-up turnaround time and A/R days
• Collaborate closely with coding, registration, billing, compliance, and internal teams to ensure clean submission and resolve root causes of denials.
• Support your teammates in achieving collective goals, ensuring our clients' continued success.
• Recommend process improvements based on denial trends and payer behavior.
• Perform other related duties as assigned.

What We're Looking For

• Minimum 3+ years of experience of hospital billing or revenue cycle experience required. in insurance follow-up, or denial management.
• Certified Revenue Cycle Representative (CRCR) offered by HFMA, Healthcare Financial Management Association, Certified Medical Reimbursement Specialist (CMRS), Certified Professional Biller (CPB), preferred, or other equivalent credentials obtained by nationally recognized entity.
• Strong knowledge and understanding of UB-04 claim forms, revenue codes, modifiers, and payer specific rules.
• Proficiency in insurance follow-up, denial management, and claims appeals.
• Excellent verbal and written communication skills
• Strong analytical and problem-solving abilities
• Ability to meet deadlines and productivity targets in a fast-paced environment
• Experience in utilizing software such as: Epic, Cerner, Meditech, SSI, IDX/Centricity, Athena, Keane, etc.
• High school diploma or equivalent required; associate degree preferred.
• Understanding of and adherence to HIPAA and compliance requirements.

Why You'll Love RSi

• Competitive pay with ample opportunities for professional growth.
• Fully remote position with a stable Monday–Friday schedule.
• Collaborative, performance-driven environment with expert leadership.
• Mission-driven work supporting essential healthcare services.
• Recognition as a nationally respected leader in healthcare revenue management.

Physical Requirements

• Comfortable working at a computer for extended periods.
• Ability to occasionally lift items weighing up to 15 pounds.

What to Expect When You Apply

Our hiring process is designed to find exceptional candidates. Once your application is received, you'll receive an invitation to complete an initial skills assessment. This step is essential: completing this assessment promptly positions you for an interview and demonstrates your commitment to excellence.

We believe in creating exceptional teams, and this process ensures that every member at RSi has the opportunity to thrive and grow.

Ready to be part of something special? Apply now and join our team!