Insurance Follow-Up Representative

About the role

The Insurance Follow-Up Representative works within the Patient Accounting department of Lehigh Valley Health Network to manage open accounts receivable, resolve underpayments and denials, and ensure accurate reimbursement from insurance carriers. This position collaborates closely with department leadership and senior management to improve billing processes and support patient financial responsibility.

Key responsibilities

• Review and manage open accounts receivable, documenting follow‑up activities that lead to resolution of underpayments and denials.
• Conduct root‑cause analysis of denials, recommend corrective actions, and escalate trends to management.
• Prepare and present reports for meetings with provider representatives and senior leadership.
• Calculate and submit adjustment and refund requests using appropriate codes and document account history.
• Identify patient out‑of‑pocket expenses and allocate responsibility within timely filing limits.

Required profile

• High School Diploma/GED with at least 2 years of professional billing or collections experience for major third‑party payers.
• Excellent verbal and written communication skills and strong analytical, mathematical, and organizational abilities.
• Successful completion of DOE and Revenue Cycle Education Training within three months of hire.

Required skills

• Proficiency with Microsoft Excel, Word, and PowerPoint.
• Knowledge of insurance contracts, reimbursement requirements, and related regulations.