Account Follow-up Representative

Harris Computer; United States; Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player is seeking a detail-oriented individual to manage hospital patient accounts and insurance claims. This role involves timely follow-up on outstanding accounts, effective communication with insurance companies, and performing in-depth research to resolve payment issues. The ideal candidate will have strong analytical skills and a knack for problem-solving, ensuring that patient accounts are handled efficiently and effectively. Join a dynamic team where your contributions will directly impact the financial health of healthcare services and enhance patient experience.

Qualifications

• Experience in managing insurance claims and patient accounts.
• Strong communication skills for effective interaction with insurance companies.

Responsibilities

• Follow up on hospital patient accounts for outstanding insurance payments.
• Communicate with insurance companies to resolve payment issues.
• Investigate non-payment causes and take appropriate actions.

Skills

Insurance Claims Management

Communication Skills

Research Skills

Problem-Solving

Education

High School Diploma

Bachelor's Degree in Healthcare Administration

Tools

MEDTEAM ticketing system

EHR system

Excel

Job description

Job Responsibilities

1. 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 within patient accounts providing steps taken to resolve outstanding insurance balance on account.
2. Work an average of 30-40 patient accounts per workday for assigned payor(s).
3. Manage an average of 30-40 patient accounts per day, focusing on denial and zero-pay reporting.
4. Work assigned Payor denials and Zero ($0) pay reports within 48 hours of receipt.
5. Communicate effectively with insurance companies for payment of outstanding insurance balances, understanding of next steps needed to reach resolution of outstanding insurance balance.
6. Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows.
7. Resolve patient accounts with outstanding insurance claims to a zero balance or advance them to the patient responsibility financial class.
8. Perform account follow-up on unpaid or partially paid insurance claims for hospital services.
9. Contact insurance payors through various methods, including telephone calls, insurance payor web portals, E-faxing, and email.
10. Investigate the cause of non-payment towards outstanding hospital claims and take appropriate actions such as: requesting insurance companies to process claims, requesting cash posting review for corrections, initiating coding reviews for account resolution, and contacting patients for insurance information.
11. Complete adjustment requests for Team Lead approval if an adjustment to the outstanding balance is needed.
12. Submit requests for claim rebilling when additional information is required, using either a shared spreadsheet or the EHR system. Utilize MEDTEAM’s ticketing system to submit claim inquiry requests if additional information or review from the hospital is required.