Insurance Follow Up Representative (Workers' Comp)

Job Description

Job Description

Job Title: Insurance Follow Up Representative (Workers' Comp)

Location (City, State): Houston, TX 77024 Hybrid remote (M,T,TH,F) and onsite (Wed) after 1-3 weeks of onsite training

Industry: Healthcare Revenue Cycle / Business Office

Pay: $21 –$23 per hour

About Our Client:

Addison Group is partnering with a leading healthcare organization to find a skilled Insurance Follow-Up/Denials Representative. This role is ideal for individuals who have strong Epic experience and are eager to work in a dynamic revenue cycle environment with long-term potential.

Job Description:

This position focuses on managing and resolving commercial insurance claims denials. The Insurance Follow-Up/Denials Representative will review claims, work payer portals, submit appeals or corrections, and ensure timely reimbursement while meeting productivity and quality standards.

Key Responsibilities:

• Work claims assigned through Epic work queues, focusing on Workers’ Compensation accounts.
• Follow up on claims with no response from the payor—these require outbound calls to determine status.
• Review and resolve billing denials such as non-covered codes, termed coverage, etc.
• Correct and resubmit claims for registration-related denials , such as incorrect subscriber information.
• Own accounts through full resolution—including correcting claims, submitting appeals, and documenting progress.
• Maintain a productivity goal of 40 invoices per day with 90% quality control (QC) compliance based on monthly audits.
• Utilize "Epic Tip Sheets"—internal guides with step-by-step instructions—for efficient resolution of common denial types.

Qualifications:

• Experience with Epic work queues and denial management preferred.
• Strong knowledge of Workers’ Compensation payors and claim workflows.
• Ability to interpret EOBs and identify denial reasons quickly and accurately.
• Comfortable working in a fast-paced, metric-driven environment.

Perks:

• Medical
• Dental
• Vision
• 401 K

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran, in accordance with applicable federal, state, and local laws. Reasonable accommodation is available for qualified individuals with disabilities upon request

IND 004-007