Account Follow Up Representative II

MEDHOST, Inc.; Nashville (TN); Remote; USD 25,000 - 36,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

3 weeks vacation + 5 personal days

401k + matching

Remote work flexibility

Job summary

MEDHOST, Inc. is seeking an Account Follow-up Representative II to review and resolve outstanding insurance balances on hospital patient accounts. You will learn multiple hospital systems, conduct research analysis, and collaborate with third-party payors to obtain information for payment resolution.

This remote role in the United States offers opportunities to manage 40-50 accounts daily, analyze denials, and support cross-team coordination while adhering to HIPAA and quality standards.

Qualifications

• Knowledge of revenue cycle processes impacting insurance reimbursements.
• Understanding of healthcare reimbursement methodologies.
• Proficiency with telephone systems and communication tools.
• Ability to access PHI per guidelines and maintain confidentiality.
• Proficiency in accurate arithmetic and data entry.

Responsibilities

• Follow up on insurance payments and rebill as needed.
• Work 40-50 accounts per day for assigned payors.
• Address denials and zero-dollar pay reports within 24 hours.
• Gather demographics, medical records, and authorizations for claims.
• Analyze denial trends and coordinate with teams to resolve issues.
• Assist leadership with projects and training for new hires.

Skills

Revenue cycle

Insurance follow-up

PHI access

Microsoft Office

Communication

Detail oriented

Teamwork

Multitasking

Education

High School diploma

Tools

Microsoft Office

Job description

The Account Follow-up Representative II is responsible for the review and resolution of outstanding insurance balances on hospital patient accounts. The Account Follow-up Representative II is required to learn multiple hospital systems, conduct research analysis, utilize intermediate skills to work basic to complex outstanding insurance claims, work closely with third party payors to answer relevant questions and obtain appropriate information in pursuit of resolving unpaid claims.

The Account Follow-up Representative II is a remote role, eligible to anyone in the U.S.

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 and 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

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 responds 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

Salary Range: $18-$26 per hour

Knowledge, Skills, and Abilities:

• 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

Training and Experience:

• 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

Other Requirements:

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

DISCLAIMER This position outlines the basic tasks and requirements for the position noted. It is not a comprehensive listing of all job duties of the associate. Management reserves the right to change the duties and responsibilities set forth herein at any time

What we Offer:

• 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

About us:

MEDHOST, founded in 1984 and headquartered in Franklin, Tennessee, is a leading provider of healthcare information technology solutions. Serving healthcare facilities nationwide, MEDHOST offers a comprehensive suite of products, including electronic health records (EHR), financial management systems, and patient engagement platforms.

Their mission is to empower healthcare organizations to enhance patient care and improve business operations through innovative, user-friendly solutions. In January 2024, MEDHOST was acquired by N. Harris Computer Corporation, further strengthening its position in the healthcare IT industry.

About Harris Computer:

Harris provides mission critical software solutions for the Public Sector, Healthcare, Utilities and Private Sector verticals throughout North America, Europe, Asia and Australia.

Working for Harris is the perfect opportunity to fulfill your professional goals as well as achieve your personal dreams!

Our employees enjoy a casual work environment that offers comfort while providing superior service to our customers. We offer a comprehensive benefit package as well as other additional perks!

• We empower our employees to make a difference
• We have an award-winning culture
• We offer opportunity to learn
• We are financially strong and we are owned by the largest software company in Canada (CSI)
• We have fun!

Follow us on social media to learn more about our company values, culture and initiatives! Instagram: @weareharris, LinkedIn: Harris Computer

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