Account Follow-Up Representative I
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Job Description
Remote Account Follow-Up Representative resolving outstanding hospital insurance claims for MEDHOST, a healthcare information technology provider. Reviewing accounts, coordinating with payors, and managing denials and appeals.
Responsibilities:
- Follow up timely on outstanding hospital patient accounts for insurance payment
- Verify claim payment status, rebill insurance, correct financial class, and document resolution steps
- Work an average of 40–50 accounts per workday
- Work assigned payor denials and zero-pay reports within 24 hours
- Gather demographic, clinical, medical record, authorization, and insurance information
- Analyze and resolve denial, variance, and payor issues with internal teams
- Prepare less complex claims for reconsiderations and appeals
- Assist leadership in managing assigned accounts receivable and resolving balances within 90 days post-discharge
- Work with third-party payors to resolve outstanding insurance balances
- Train new hires and assist less experienced representatives
- Research patient accounts and route them through appropriate workflows
- Review and recommend account adjustments according to guidelines
- Complete projects supporting client contractual service agreements
- Maintain the MEDHOST Quality Management System and meet regulatory requirements
- Attend role-based education, meetings, and training
- Submit worked time accurately and maintain knowledge of payors and collection regulations
- Respond to communications from patients, agencies, and facilities
- Adhere to HIPAA privacy and security requirements
Requirements:
- High Speed Internet access (minimum 300 Mbps download speed) and unlimited data
- Smart phone for Multi Factor Authentication (MFA) application
- Knowledge of revenue cycle processes impacting insurance reimbursements
- Knowledge of insurance follow-up processes and healthcare reimbursement methodologies
- Proficiency with telephone systems for outbound/inbound calls
- Ability to access protected health information (PHI) according to guidelines
- Accurate arithmetic computations
- Excellent communication, judgment, tact, initiative, and resourcefulness
- Detail oriented, organized, and able to multi-task
- Ability to concentrate for long periods of time
- Ability to work independently and/or as part of a team
- Ability to learn new systems quickly
- High School or equivalent diploma required
- 3+ years' experience in related field
- Ability to follow directions and perform work independently
- Microsoft Office applications, including Word, Excel, and PowerPoint
- Customer service orientation
Benefits:
- 3 weeks’ vacation and 5 personal days
- Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment
- Employee stock ownership
- RRSP/401k matching programs
- Lifestyle rewards
- Remote work
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