Follows up with payers and patients on insurance claims, resolves rejections, verifies eligibility and coordination of benefits, reviews payer correspondence, submits corrected or secondary claims, investigates payment retractions, and monitors claim-processing trends while meeting productivity and quality goals.
Key Responsibilities:
- Follow up on claim status via insurance portals or calls to payers to determine adjudication and details.
- Call payers and patients as needed to resolve claim rejections, challenge processing decisions, and verify insurance coverage.
- Verify patient insurance eligibility and coordination of benefits.
- Review and analyze payer correspondence.
- Investigate electronic claim rejections.
- Submit claims for processing corrections, to secondary insurances, or to updated addresses.
- Research requests for insurance payment retractions.
- Monitor and notify management of payer trends and/or claim processing issues.
- Meet or exceed productivity and quality KPI goals.
- Perform other duties as assigned.
Education/Experience:
- High School diploma or GED
- Previous health insurance billing experience
- Working knowledge of medical terminology
- Strong problem-solving skills and the ability to adapt to changes in policies, regulations, and procedures
- Excellent written and verbal communication skills
- High attention to detail
- Ability to interact effectively with others
- Ability to maintain confidentiality
- Proficient computer skills with knowledge of Microsoft Word and Excel
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Similar Jobs
Insurance • Financial Services
Verifies life and health insurance applications through outbound calls, documents information for underwriting, explains application procedures, completes paperwork, updates quality assurance records, transfers calls, and meets departmental KPIs. The role requires strong customer service, accurate data entry, multitasking, organization, computer proficiency, and preferably bilingual English-Spanish communication. This is a part-time remote position.
Top Skills:
MS OfficeQuality Assurance Database
Insurance • PropTech
Sell property and casualty insurance to inbound leads, determine appropriate policies, prepare quotes, follow up with clients, track sales activity in Salesforce, follow underwriting guidelines, and close business. The role requires expertise across builders risk, landlord, commercial property, general liability, and flood insurance products, along with an active P&C license and a customer-focused approach.
Top Skills:
Property & Casualty InsuranceSalesforce
Healthtech
Verifies insurance eligibility and benefits, calculates patient financial responsibility, confirms authorizations and referrals, reviews medical necessity, and completes pre-registration for inpatient and outpatient services. The role documents records, communicates with patients and healthcare staff, educates patients about coverage, processes orders, and supports revenue cycle financial clearance. This is a remote position requiring accuracy, organization, and knowledge of insurance and healthcare information systems.
Top Skills:
Eligibility PortalsEmrHealthcare Information SystemsMicrosoft Office Suite
What you need to know about the NYC Tech Scene
As the undisputed financial capital of the world, New York City is an epicenter of startup funding activity. The city has a thriving fintech scene and is a major player in verticals ranging from AI to biotech, cybersecurity and digital media. It also has universities like NYU, Columbia and Cornell Tech attracting students and researchers from across the globe, providing the ecosystem with a constant influx of world-class talent. And its East Coast location and three international airports make it a perfect spot for European companies establishing a foothold in the United States.
Key Facts About NYC Tech
- Number of Tech Workers: 549,200; 6% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Capgemini, Bloomberg, IBM, Spotify
- Key Industries: Artificial intelligence, Fintech
- Funding Landscape: $25.5 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Greycroft, Thrive Capital, Union Square Ventures, FirstMark Capital, Tiger Global Management, Tribeca Venture Partners, Insight Partners, Two Sigma Ventures
- Research Centers and Universities: Columbia University, New York University, Fordham University, CUNY, AI Now Institute, Flatiron Institute, C.N. Yang Institute for Theoretical Physics, NASA Space Radiation Laboratory
