Account Follow-Up Representative II
Posted 7ds ago
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Job Description
Remote Account Follow-Up Representative resolving hospital insurance claims for MEDHOST, a healthcare information technology provider. Managing patient accounts, payor denials, appeals, and reimbursement workflows.
Responsibilities:
- Review and resolve outstanding insurance balances on hospital patient accounts
- Learn and work across multiple hospital systems
- Research and analyze basic to complex outstanding insurance claims
- Follow up on outstanding accounts, verify claim payment status, rebill insurance, correct financial class, and document resolution steps
- Work an average of 40–50 accounts per workday for assigned payors
- Work assigned payor denials and zero-pay reports within 24 hours
- Gather demographic, clinical, medical record, authorization, and insurance information needed to pay claims
- Analyze and communicate denial, variance, and payor issues with internal teams and departments
- Prepare less complex claims for reconsiderations and appeals
- Assist leadership in managing assigned accounts receivable and resolving balances at 90 days post-discharge
- Work with third-party payors to resolve outstanding balances
- Deliver education and training to new hires and assist less experienced representatives
- Research patient accounts and route them through appropriate workflows
- Review and recommend account adjustments according to payor, company, and client guidelines
- Complete projects assigned by team lead or manager
- Partner with teams and departments to resolve project issues, concerns, and workflows
- Maintain MEDHOST Quality Management System effectiveness and implementation
- Attend role-based education courses and complete special projects
- Accurately submit worked time by departmental deadlines
- Maintain knowledge of insurance payors and collection regulations
- Attend training classes, team meetings, and departmental meetings
- Respond promptly to emails, telephone calls, voicemails, Microsoft Teams messages, and correspondence
- Adhere to HIPAA Privacy and Security requirements
- Perform duties in accordance with company policies and procedures
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 healthcare reimbursement methodologies
- Proficiency with telephone systems for outbound/inbound calls
- Ability to access protected health information (PHI) in accordance with departmental assignments and guidelines
- Skilled in making accurate arithmetic computations
- Excellent communication, good judgment, tact, initiative, and resourcefulness
- Detail oriented, organized, and able to multi-task
- Ability to concentrate for long periods of time
- Ability to work individually and/or as part of a team
- Ability to learn new systems quickly and develop proficient operating skills within a reasonably short timeframe
- Ability to understand oral and written directives
- Ability to follow directions and perform work independently according to department standards
- Microsoft Office proficiency, including Word, Excel, and PowerPoint
- Customer service oriented
- High Speed Internet access with minimum 300 Mbps download speed and unlimited data
- Smartphone for Multi Factor Authentication (MFA) application
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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