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What are the key skills and qualifications needed to thrive as a Remote Insurance Follow Up Specialist, and why are they important?

To thrive as a Remote Insurance Follow Up Specialist, you need a solid understanding of medical billing, insurance processes, and claims resolution, often supported by experience in healthcare administration or a related certification. Familiarity with billing software, electronic health records (EHR) systems, and payer portals is typically required. Strong attention to detail, effective communication, and problem-solving skills are essential soft skills for success in this role. These skills ensure accurate claim processing, timely reimbursement, and positive interactions with both payers and patients.

What are common challenges faced in a Remote Insurance Follow Up role, and how can they be managed?

A common challenge in a Remote Insurance Follow Up role is navigating different insurance company processes and resolving claim denials efficiently. Communication barriers can arise when working remotely, making it crucial to be proactive in following up on claims and keeping accurate records. Staying organized, using comprehensive tracking systems, and maintaining clear communication with both insurance companies and internal billing teams help overcome these challenges. Additionally, regular training on policy updates and leveraging collaboration tools can enhance productivity and ensure claims are processed in a timely manner.

What is a Remote Insurance Follow Up specialist?

A Remote Insurance Follow Up specialist is a professional who works, often from home, to ensure that healthcare providers receive proper payment from insurance companies. They review outstanding claims, contact insurance companies to resolve issues, and update billing records accordingly. Their role is crucial in identifying and addressing claim denials or delays, helping improve the financial health of medical practices or hospitals. Strong communication, attention to detail, and knowledge of medical billing are essential for this position.

What is the difference between Remote Insurance Follow Up vs Remote Claims Processor?

AspectRemote Insurance Follow UpRemote Claims Processor
Required CredentialsInsurance knowledge, customer service skillsInsurance policies, claims processing certifications
Work EnvironmentHome-based, customer communicationHome-based, data entry and review
Employer & Industry UsageInsurance companies, agenciesInsurance carriers, third-party administrators
Common Search & Comparison IntentFollow-up tasks, customer communicationClaims handling, processing procedures

Remote Insurance Follow Up primarily involves communicating with clients to follow up on insurance matters, while Remote Claims Processor focuses on reviewing and processing insurance claims. Both roles require insurance knowledge but differ in daily tasks and responsibilities within the insurance industry.

What are popular job titles related to Remote Insurance Follow Up jobs in Oregon? For Remote Insurance Follow Up jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Follow Up jobs in Oregon look for? The top searched job categories for Remote Insurance Follow Up jobs in Oregon are:
What cities in Oregon are hiring for Remote Insurance Follow Up jobs? Cities in Oregon with the most Remote Insurance Follow Up job openings:
Remote Insurance Follow Up jobs near you
Infographic showing various Remote Insurance Follow Up job openings in Oregon as of May 2026, with employment types broken down into 2% As Needed, 59% Full Time, 26% Part Time, 2% Temporary, 10% Contract, and 1% Nights. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution.
Denials Management Follow Up Representative

Denials Management Follow Up Representative

Shriners Children's

Remote

Full-time

Medical, Life, Retirement, PTO

Posted 6 days ago

Shriners Children's rating

7.9

Company rating: 7.9 out of 10

Based on 44 frontline employees who took The Breakroom Quiz

140th of 989 rated hospitals

Job description

Company Overview

#LI-Remote

Shriners Children's is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for our children and their families.

All employees are eligible for medical coverage on their first day! In addition, upon hire all employees are eligible for a 403(b) and Roth 403(b) Retirement Saving Plan with matching contributions of up to 6% after one year of service. Employees in a FT or PT status (40+ hours per pay period) will also be eligible for paid time off, life insurance, short term and long-term disability and the Flexible Spending Account (FSA) plans and a Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected. Additional benefits available to FT and PT employees include tuition reimbursement, home & auto, hospitalization, critical illness, pet insurance and much more! Coverage is available to employees and their qualified dependents in accordance with the plans. Benefits may vary based on state law.

Job Overview

The Denials Management Follow Up Representative is responsible for following up on payor responses to Shriners Children's submitted appeals. The Representative will contact insurance carriers to ensure timely payment and collection of money due to the Shriners Children's organization after the appeals process has successfully taken place.

Responsibilities
  • Coordinating payor denial and appeal follow up activities to ensure timely response from third party payors and the processing of all payor denials, documentation requests and appeals for both institutional and professional claims.
  • Communicating and coordinating with various individuals/distributions and assisting with monitoring of the day to day activities related to appeal follow up and denials.
  • Maintaining the hospital tracking tool/application that stores/communicates all denial and review activity. This will include user access management, updates to software, and end-user training to support all follow-up activities.
  • Collecting/analyzing, report status, metrics and trends of activity by different reviews from multiple systems. Developing reports on a routine basis to specific distribution group.
  • Organizing all data and activity in a retrievable way to ensure timely follow up on appeals to third party payors.
  • Assisting with the coordination of denial and review activities and materials for committee meetings, including analyses, reports, etc.
  • Supporting projects and initiatives of the Revenue Integrity team. This may include coordinating meetings, conducting research for payor criteria, and preparing documents.
  • Strong communication skills and a commitment to delivering the highest level of quality work.

This is not an all-inclusive list of this job's responsibilities. The incumbent may be required to perform other related duties and participate in special projects as assigned.

Qualifications

Required:

  • 5-7 Years in a healthcare patient accounting revenue cycle environment
  • Knowledge of Hospital Revenue Cycle revenue management EDI Transaction sets including 837I, 837P Insurance contract rates and terms
  • Understanding of Registration and Collections
  • Understanding of Government and Managed Care billing, coverage and payment rules
  • Ability to comprehend payor 835 and paper EOB responses
  • Understanding of CCI edits, CPT, HCPCS, ICD-10 and Revenue Codes
  • Epic EMR (HB and/or PB)
  • Bachelor's Degree or equivalent combination of education and experience in lieu of degree

Preferred:

  • 3 years in Hospital Third Party Collection/AR Receivables
Employment Type: FULL_TIME

What Shriners Children's employees say

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