Insurance Follow Up Rep - 252898

Medix is hiring on behalf of a nationally recognized healthcare system for an experienced Managed Medicare AR Follow-Up Specialist to support physician billing and complex payer resolution efforts. This role is ideal for someone who enjoys researching challenging accounts, working complex denials, and navigating Managed Medicare payer guidelines.Schedule & Work EnvironmentFull-Time | Monday–FridaySchedule: 8:00 AM – 5:00 PMTraining will be onsite for the first 3–4 weeksAfter training: Hybrid schedule with 1 onsite day per week (Wednesdays) and the remainder remotePosition OverviewThis position is responsible for collecting and resolving outstanding Managed Medicare accounts receivable for a large physician group. The ideal candidate will have strong insurance follow-up experience, deep knowledge of Medicare Advantage/Managed Medicare payers, and a proven ability to resolve complex claims and overturn denials.Candidates must be highly analytical, organized, and comfortable working in a fast-paced, high-volume environment while maintaining strong quality and productivity standards.ResponsibilitiesClaims Follow-Up & Denial ResolutionPerform follow-up on outstanding insurance claims with Managed Medicare payersInvestigate claim denials, underpayments, rejections, and delayed paymentsResearch complex accounts and identify missing documentation or billing discrepanciesPrepare and submit reconsiderations and appealsBring claims to full resolution through proactive follow-up effortsPrioritize accounts based on payer guidelines and aging reportsAccurately document all account activity and follow-up efforts within EPICPayment Posting & ReconciliationVerify and post payments accuratelyReconcile patient accounts and identify discrepanciesProcess adjustments, refunds, and write-offs as neededResearch and resolve payment posting issuesCommunication & CollaborationCommunicate professionally with insurance representatives, patients, and internal departmentsCollaborate with billing, medical records, and patient access teams to resolve account issuesRespond to inquiries in a timely and professional mannerCompliance & ReportingMaintain accurate account documentation and collection recordsParticipate in monthly quality assessmentsFollow departmental tip sheets and payer guidelinesEnsure compliance with HIPAA and organizational policiesRequired QualificationsMinimum 2 years of physician billing experienceMinimum 2 years of EPIC experienceStrong insurance follow-up experience involving denials and rejectionsProven success overturning denials and resolving complex claimsExperience preparing appeals and reconsiderationsStrong understanding of Medicare and Managed Medicare/Medicare Advantage payersExcellent analytical and problem-solving skillsAbility to research accounts thoroughly and identify root-cause issuesPreferred QualificationsAbility to multitask in a fast-paced, high-volume environmentStrong Microsoft Office skills, especially ExcelExperience with 10-key and basic math functionsPerformance ExpectationsProductivity standard: 45 accounts per dayQuality standard: 90% or higher accuracyQuality metrics include accurate notation and timely follow-throughWhat Makes This Opportunity Stand OutHybrid flexibility after trainingOpportunity to work for a top nationally recognized health systemStrong team environment with structured onboarding and ongoing quality supportIdeal role for candidates who enjoy solving challenging payer and denial issuesIf you have strong Managed Medicare experience and enjoy working complex AR accounts from denial through resolution, we'd love to connect with you.