[Hiring] Account Follow-Up Representative I @Harris Computer

Role Description

The Account Follow-up Representative II is responsible for the review and resolution of outstanding insurance balances on hospital patient accounts. This remote role welcomes candidates anywhere in the US.

Wage: $18-$26/hr

AI & Innovation Mindset: We are committed to leveraging emerging technologies to improve how we work, serve our customers, and drive business outcomes. The successful candidate will demonstrate curiosity and a willingness to actively adopt and leverage AI tools to improve workflows, solve problems, and increase efficiency.

What your impact will be:

• 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
  • 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

Qualifications

• 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
• High School or equivalent diploma required
• 3+ years' experience in related 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

Requirements

• High Speed Internet access (minimum 300 Mbps download speed) and unlimited data
• Smart phone for Multi Factor Authentication (MFA) application

Benefits

• 3 weeks’ vacation and 5 personal days
• Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment
• Employee stock ownership and RRSP/401k matching programs
• Lifestyle rewards
• Remote work and more!