Follow Up Representative

Insight Global is looking for a Follow‑Up Representative to support a large hospital system in the Maryland/DC area. This person will support the Denials Appeals & Performance (DAP) team, a centralized hospital denial group supporting 10 hospitals across the Maryland/DC region.
This role focuses on post‑appeal and post‑submission insurance follow‑up, helping offload administrative and payer‑chasing work from RN teams. Follow‑Up Reps will manage a mixed inpatient and outpatient inventory, working with primarily commercial payers and MCOs. This is not an appeal‑writing role, though there is opportunity for growth and cross‑training over time. The environment is fast‑paced, documentation‑driven, and collaborative, with a strong emphasis on accuracy, persistence, and accountability.

Primary Responsibilities
• Perform post‑appeal insurance follow‑up on hospital denial accounts
○ Productivity is quality‑focused, not quota‑driven
○ Looking for someone who has experience touching <40 accounts/day
• Check claim and appeal status via:
○ Payer portals
○ Phone calls to insurance companies
○ Written payer correspondence
• Work accounts originating from:
○ Denials Appeals & Performance (DAP) RNs
○ Acute Case Management (ACM) RNs
• Document all follow‑up actions clearly in the appropriate system
• Identify cases with insufficient or unclear documentation and escalate appropriately
• Track payer responses, timelines, and next steps
• Support rebilling or resubmission efforts when required
• Navigate long hold times and high‑touch payer follow‑up while maintaining productivity
• Collaborate with:
○ RN reviewers
○ Other follow‑up representatives
○ Leadership as needed
• Participate in:
○ Team huddles
○ Workflow updates
○ Ongoing training and cross‑training initiatives
• Adapt to evolving workflows as the DAP team continues to expand and absorb new workstreams

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

• High school diploma or equivalent
• Facility / hospital billing experience
○ (Not physician or professional billing)
• Experience with hospital insurance follow‑up
○ Post‑billing follow‑up preferred
○ Claim status checks, payer correspondence, rebilling, or collections‑type work
• Experience working with managed care / commercial payers
• Experience navigating payer portals
○ (e.g., Availity, CareFirst/BCBS portals, UnitedHealthcare, Aetna, etc.)
• Strong ability to document follow‑up actions clearly and accurately
• Comfort working across multiple systems and workflows simultaneously
• Ability to work independently in a remote environment
• Strong attention to detail and ability to stay organized with large inventories
• Willingness to learn and cross‑train into additional denial workflows over time
• Strong follow‑through, responsiveness, and ability to follow direction

• Experience supporting denials or appeals teams
• Familiarity with:
○ Hospital denial workflows
○ Managed care escalation processes
• Familiarity with CARC (claim adjustment reason) codes and denial‑reason–based work routing
• Experience with UB‑04 forms
• Experience with systems such as:
○ RCI (denial repository)
○ Epic
○ Med‑Connect (medical records)
○ Envision / SMS
• Experience with Maryland and/or Washington, DC reimbursement
• Certifications:
○ CHAA (Certified Healthcare Access Associate)
CRCS‑I (Certified Revenue Cycle Specialist – Insurance)

Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.