Account Follow Up Representative II
Posted 7ds ago
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Job Description
Remote Account Follow-up Representative resolving outstanding hospital insurance claims for MEDHOST, a healthcare information technology provider. Managing payor follow-up, denials, appeals, and patient account workflows.
Responsibilities:
- Review and resolve outstanding insurance balances on hospital patient accounts
- Learn multiple hospital systems and conduct research analysis
- Work basic to complex outstanding insurance claims
- Work closely with third-party payors to resolve unpaid claims
- Follow up on outstanding hospital patient accounts and verify claim payment status
- Rebill patient insurance, correct financial class, and document resolution steps
- Work an average of 40–50 accounts per workday
- Process assigned payor denials and zero-pay reports within 24 hours
- Gather demographic, clinical, medical-record, authorization, and insurance information
- Analyze and communicate denial/variance trends and payor issues
- Prepare less complex claims for reconsiderations and appeals
- Assist leadership in managing assigned accounts receivable and resolving balances within 90 days post-discharge
- Deliver education and training for 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 assigned by team leads or managers
- Collaborate with internal teams and departments on project issues and workflows
- Maintain MEDHOST Quality Management System effectiveness and meet regulatory requirements
- Attend role-based education courses, meetings, and training
- Respond to emails, calls, voicemails, Microsoft Teams messages, and correspondence
- Accurately submit worked time by departmental deadlines
- Maintain knowledge of insurance payors and collection regulations
- Adhere to HIPAA privacy and security requirements
- Perform other duties as assigned
Requirements:
- High School or equivalent diploma required
- 3+ years’ experience in related medical field
- Knowledge of revenue cycle processes impacting insurance reimbursements
- Knowledge of insurance follow-up processes and fundamental healthcare reimbursement methodologies
- Proficiency with telephone systems for outbound/inbound calls
- Ability to access protected health information (PHI) according to guidelines
- Skilled in accurate arithmetic computations
- Excellent communication, good judgment, tact, initiative, and resourcefulness
- Detail oriented, organized, and able to multitask
- 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
- Sufficient in Microsoft Office applications, including Word, Excel, and PowerPoint
- Customer Service oriented
- High Speed Internet access with minimum 300 Mbps download speed and unlimited data
- Smart phone for Multi Factor Authentication (MFA) application
- Ability to follow HIPAA Privacy and Security requirements
Benefits:
- Plenty of opportunities to grow your career
- Comprehensive medical, dental, and vision benefits
- 3 weeks of vacation plus 5 personal days to recharge
- Employee stock ownership
- RRSP program
- 401k + matching
- A chance to give back through community involvement
- Flexible work arrangements to suit your lifestyle
- Casual work environment
- Comprehensive benefit package
- Opportunity to learn
- Award-winning culture
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