Account Follow Up Representative II

MediSolution; Tennessee; Hybrid; USD 25,000 - 36,000; Full time

Benefits offered by this job

Medical benefits

Vacation + personal days

401k + matching

Job summary

MEDHOST is seeking an Account Follow-up Representative II to review and resolve outstanding insurance balances on hospital patient accounts. The role is remote in the U.S. and requires researching multiple hospital systems, analyzing denial trends, and coordinating with third-party payors.

You will handle ~40-50 accounts per day and educate new hires as needed. Ideal candidates have 3+ years in a related medical field, proficiency with Microsoft Office, and strong communication skills.

Qualifications

• Knowledge of revenue cycle processes affecting insurance reimbursements.
• Knowledge of insurance follow-up concepts in healthcare reimbursement.
• Proficient with telephone systems for outbound/inbound calls.

Responsibilities

• Timely follow-up on hospital patient accounts outstanding for insurance payment.
• Verify claim payment status and rebill to insurance.
• Gather demographic, clinical information and insurance data to resolve claims.

Skills

Revenue cycle

Insurance follow-up

Telephone systems

PHI access

Numerical accuracy

Communication

Attention to detail

Time management

Team collaboration

Adaptability

Education

High School diploma

Tools

Microsoft Word

Microsoft Excel

PowerPoint

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

What we look for:

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 #LI-remote 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!

Harris is an Equal Opportunity/Affirmative Action Employer. We consider applicants without regard to race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other group protected by federal, state or local law. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at (1)-613-226-5511 or at [e-mail]. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.