Insurance Follow Up Representative

Job description

Drive timely reimbursements that keep patient care moving forward

From CPT codes to claim cycles, the health insurance industry thrives on detail-and so can you.

Become the expert who keeps reimbursements in check and providers in balance.

This role puts you at the center of healthcare's financial pulse while letting you build a career that truly pays off.

What You'll Be Doing

Be part of our client's team as an
Insurance Follow-Up Representative - Claims
You will handle denial resolution, insurance follow-up, and appeals to ensure timely reimbursement while maintaining compliance and collaborating with teams.

Your work helps healthcare providers deliver care without financial obstacles.

Key Role Details

Employment type: Indefinite term contract

Shift: Morning shift, Monday-Friday, 8am-5pm EST

Work setup: Onsite, Calle 97A, Bogotá

What's In It for You

• Competitive pay with ample opportunities for professional growth
• 5-day work week, weekends off
• 20 vacation days in total
• Prepaid medicine
• Fully customized Emapta laptop and peripherals
• Direct exposure to our clients
• Career growth opportunities
• Diverse and supportive work environment
• Prime office locations in Bogotá and Medellín
• Unlimited upskilling through Emapta Academy courses (Visit: )
• Collaborative, performance-driven environment with expert leadership
• Mission-driven work supporting essential healthcare services

What You'll Need to Succeed

• Minimum 3+ years of experience in medical billing or insurance follow-up, preferably in a healthcare or hospital setting
• Strong understanding of
  insurance payers, claim life cycles, and denial management
• Proficiency with
  CMS-1500, CPT, HCPCS, ICD-10, EOBs, and payer-specific policies
• Rural Health Clinic experience preferred
• Experience using systems such as
  Epic, Cerner, Meditech, SSI, IDX/Centricity, Athena, Keane, etc.
  
  
• Strong organizational and communication skills, with the ability to manage multiple tasks independently
• High school diploma or equivalent required; associate degree preferred
• Preferred certifications: CRCR (HFMA), CPB (AAPC), CMRS (AMBA)
• Knowledge of and adherence to
  HIPAA and other regulatory compliance requirements

Physical Requirements:

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

How You'll Make an Impact

Denial Resolution and Appeals

• Perform follow-up on outstanding insurance and patient balances via payer portals, phone, or correspondence
• Analyze denials, identify trends, and recommend improvements
• Investigate unpaid or denied claims to ensure timely reimbursement
• Submit appeals, corrected claims, and documentation in compliance with payer guidelines

Follow-Up and Review

• Resolve claim issues related to medical necessity, authorization, bundling, or eligibility
• Verify or obtain insurance information directly from patients

Underpayment Review

• Identify underpaid claims based on contract terms
• Research and dispute underpayments with payers, collaborating with contract management

Process and Workflow

• Document all actions accurately in workflow management systems
• Use internal resources and escalate unresolved issues as needed
• Meet productivity and quality standards
• Support onboarding of new team members

Collaboration and Strategy

• Work closely with coding, billing, compliance, and patient access teams
• Ensure compliance with CMS, Medicaid, and commercial payer guidelines
• Recommend process improvements based on denial trends
• Support teammates in achieving collective goals

Who You'll Work With

For more than 20 years, our client has been a
trusted leader in revenue cycle management services for hospitals and large physician practices across the U.S.
With the 2023 acquisition of Invicta Health Solutions, they expanded their reach with advanced technology integrations and partnerships.

What sets them apart is their People First approach-building teams of sharp, committed professionals who deliver best in class patient financial experiences.

At our client's team, career growth and balance go hand in hand, making them an employer of choice in healthcare revenue cycle management.

Your Future Team at Emapta Latam

Join Emapta Latam and contribute to our legacy of transforming global outsourcing.

Since 2010, Emapta has pioneered personalized outsourcing solutions, empowering businesses to thrive with bespoke teams and seamless integration.

Our commitment to excellence is reflected in our state-of-the-art facilities, competitive compensation, and a supportive work environment that fosters professional growth.

With over 1,000 clients worldwide and a team of over 10,000 talented professionals, Emapta continues to set new standards in the industry.

Apply now to be part of our success story in Colombia, where your skills are valued, and your career ambitions are supported.

#EmaptaEra

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