[Hiring] Account Follow-Up Representative II @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 role requires learning multiple hospital systems, conducting research analysis, and utilizing intermediate skills to work on basic to complex outstanding insurance claims.

This 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
  • 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 ensures 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 respond 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

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

Requirements

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

Salary Range

$18-$26 per hour

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