Account Follow-Up Representative II

Job Description:

• Review and resolve outstanding insurance balances on hospital patient accounts
• Learn and work across multiple hospital systems
• Research, analyze, and resolve 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
• Analyze and help resolve denial, variance, and payor issues with other teams
• Prepare less complex claims for reconsiderations and appeals
• Assist leadership with assigned accounts receivable and resolve outstanding insurance balances at 90 days post-discharge
• Work with third-party payors to resolve outstanding balances
• 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 team lead or manager-assigned projects and support client contractual service requirements
• Partner with other teams on project issues, concerns, and workflows
• Maintain the MEDHOST Quality Management System and meet regulatory requirements
• Attend role-based education courses and assist with special projects
• Submit worked time accurately by departmental deadlines
• Maintain knowledge of insurance payors and collection regulations
• Attend training, team meetings, and departmental meetings
• Respond promptly to emails, calls, voicemails, Microsoft Teams messages, and correspondence
• Adhere to HIPAA privacy and security requirements

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) according to guidelines
• Skilled in accurate arithmetic computations
• 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 proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint
• High-speed Internet access with minimum 300 Mbps download speed and unlimited data
• Smartphone for Multi Factor Authentication (MFA) application
• Ability to follow directions and perform work independently according to department standards
• Ability to function effectively under high-pressure situations
• Customer service orientation

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