[Hiring] Account Resolution Representative II @Wellstar Health System

Role Description

Under the direction of the Manager of Account Resolution, the Account Resolution Representative II assists with planning and coordinating HB Accounts Resolution follow-up activities for an account receivable portfolio of approximately $375M-$500M. Responsibilities include:

• Collaboratively working with Team Lead and Manager.
• Assisting with training employees as circumstances dictate.
• Developing strategies for a continuous improvement work environment.
• Ensuring eligible accounts are reviewed, appealed, escalated, or adjusted within designated payer time frames.
• Providing educational support in various departmental and individual settings.
• Conducting data analysis and trending analysis regarding payor and revenue cycle business processes.

The role requires a strong understanding of billing, collections, denial management, and provider/payor appeal requirements, as well as proficiency in MS Office applications.

Core responsibilities include:

• Maintaining compliance with departmental billing and follow-up policies.
• Responding to inquiries from third parties, insurance providers, and patients.
• Collecting and resolving payments from insurance companies.
• Researching and resolving payer rejected/denied claims.
• Assisting with staff training and oversight.
• Monitoring progress for assigned workflow and providing feedback to leadership.
• Maintaining a positive team attitude and resolving complaints in a timely manner.
• Acting as an internal resource for problem resolution.
• Maintaining ongoing communication with other departments.
• Assisting with the development of Insurance Follow-Up and Denial policies.

Qualifications

• High School Diploma / GED General.
• Certified Revenue Cycle Representative within 180 Days (Preferred).
• Minimum 1 year experience as an Account Follow-up Representative I or 2 years in hospital patient financial services or related area.
• Thorough understanding of governmental and non-governmental healthcare revenue cycle functions.

Requirements

• Strong interpersonal, mathematical, analytical, computer, problem-solving, and writing skills.
• Comfortable interacting with insurance providers, physicians, and leadership.
• Ability to perform a wide variety of tasks requiring independent judgment and initiative.
• Competent with MS Word, PowerPoint, and MS Excel.
• Ability to establish a cohesive work team and maintain performance levels.
• Ability to work efficiently under pressure and deal with constant change.
• Commitment to continuous learning and effective handling of difficult situations.

Benefits

• Support for meaningful work and a rewarding life.
• Integration into the most comprehensive health system in Georgia.