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The Account Follow-up Representative II is responsible for the review and resolution of outstanding insurance balances on hospital patient accounts. The Account Follow-up Representative II is required to learn multiple hospital systems, conduct research analysis, utilize intermediate skills to work basic to complex outstanding insurance claims, work closely with third party payors to answer relevant questions and obtain appropriate information in pursuit of resolving unpaid claims.
The Account Follow-up Representative II is a remote role, eligible to anyone in the U.S.
What your impact will be:
Responsibilities:
Timely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient’s insurance, proration to correct financial class and notation of patient accounts with steps taken for resolution
Work an average of 40-50 accounts per workday for assigned payor(s)
Assigned Payor denials and Zero ($0) pay reports worked within 24 hours of receipt
Gather additional demographic, clinical information, medical records, authorizations, and insurance related information deemed necessary to pay outstanding medical claims and update the applicable systems with the patient’s information
Ability to prioritize job responsibilities and manage time effectively for completion of assignments
Analyze, communicate, and participate in resolving denial/variance trends and payor issues with other teams/departments within the organization
Identifies and prepares less complex claims for reconsiderations and appeals
Assists leadership in managing assigned A/R and ensure resolution of outstanding insurance balances at 90 days post discharge
Works closely with third party payors and takes next steps to reach resolution of outstanding insurance balances.
Must have the ability to deliver education and training for new hires along with assisting less experienced representatives.
Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows
Review and recommend adjustments to accounts in accordance with the payor, company, and client guidelines
Participate in and complete projects assigned by team lead or manager to fulfill clients’ contractual agreement of services
Work in partnership with other teams/departments regarding resolution of project issues, concerns, and workflows
Maintain the effectiveness and implementation of the MEDHOST Quality Management System and meet applicable regulatory requirements as needed
Responsible for QMS procedures listed in QMS Procedure Crosswalk found in QMS Manual as applicable.
Attend role-based education courses within the calendar year
Assists leadership with special projects and/or stretch assignments
Other duties as assigned
Administrative Duties:
Accurately input/submit worked time by the required departmental deadlines
Maintain knowledge of insurance payors and collection regulations
Maintain industry knowledge through self-study and by attending training classes
Attend and participate in team and departmental meetings
Effectively responds to emails, telephone calls, voicemails, Microsoft Teams messages, and correspondence from patients, agencies, and facilities in a timely manner
Adherence to all HIPAA Privacy and Security requirements and responsibilities
Perform duties and responsibilities in a positive manner that upholds company policies and procedures
Salary Range: $18-$26 per hour
What we look for:
Knowledge, Skills, and Abilities:
Knowledge of revenue cycle processes impacting insurance reimbursements
Knowledge of insurance follow-up processes with understanding of the fundamental concepts in healthcare reimbursement methodologies
Proficiency with telephone systems for outbound/inbound calls
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
Must be detail oriented, organized, and ability to multi-task
Possess ability to concentrate for long periods of time
Ability to work individually and/or as part of a team
Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives
Must be flexible with a “can do” attitude and the ability to remain professional under high pressure situations
Demonstrates the ability to learn new systems quickly and develop proficient operating skills within a reasonably short timeframe
Understand both oral and written directives
Training and Experience:
High School or equivalent diploma required
3+ years’ experience in related medical field
Must be able to follow directions and to perform work according to department standards independently
Must be emotionally mature and able to function effectively under high pressure situations
Sufficient in Microsoft Office applications (i.e., Word, Excel, PowerPoint, etc.) to complete work assigned
Customer Service oriented
Other Requirements:
High Speed Internet access (minimum 300 Mbps download speed) and unlimited data
Smart phone for Multi Factor Authentication (MFA) application
DISCLAIMER
This position outlines the basic tasks and requirements for the position noted. It is not a comprehensive listing of all job duties of the associate. Management reserves the right to change the duties and responsibilities set forth herein at any time
What we Offer:
Plenty of opportunities to grow your career
Comprehensive medical, dental, and vision benefits
3 weeks of vacation plus 5 personal days to recharge
A chance to give back through community involvement
Flexible work arrangements to suit your lifestyle
About us:
MEDHOST, founded in 1984 and headquartered in Franklin, Tennessee, is a leading provider of healthcare information technology solutions. Serving healthcare facilities nationwide, MEDHOST offers a comprehensive suite of products, including electronic health records (EHR), financial management systems, and patient engagement platforms.
Their mission is to empower healthcare organizations to enhance patient care and improve business operations through innovative, user-friendly solutions. In January 2024, MEDHOST was acquired by N. Harris Computer Corporation, further strengthening its position in the healthcare IT industry.
About Harris Computer:
Harris provides mission critical software solutions for the Public Sector, Healthcare, Utilities and Private Sector verticals throughout North America, Europe, Asia and Australia.
Working for Harris is the perfect opportunity to fulfill your professional goals as well as achieve your personal dreams!
Our employees enjoy a casual work environment that offers comfort while providing superior service to our customers. We offer a comprehensive benefit package as well as other additional “Perks”!
We empower our employees to make a difference We have an award-winning culture We offer opportunity to learn We are financially strong and we are owned by the largest software company in Canada (CSI) We have fun!
Follow us on social media to learn more about our company values, culture and initiatives! Instagram: @weareharris, LinkedIn: Harris Computer Originally posted on Himalayas
