Accounts Receivable Associate - RCM Only

Bizmatics India -Harris; United States; Remote; USD 40,000 - 70,000; Full time

Job summary

Join a dynamic team where you'll play a pivotal role in resolving outstanding insurance balances for hospital accounts. As an Account Follow-up Representative I, you'll engage with various hospital systems and insurance companies, ensuring timely follow-up and resolution of claims. This position offers an exciting opportunity to utilize your communication skills and attention to detail in a supportive environment. If you thrive under pressure and enjoy helping others, this role is perfect for you. Be part of a forward-thinking organization that values its employees and fosters professional growth.

Qualifications

• 5-7 years experience in account follow-up for hospital insurance claims.
• Bilingual skills required for effective communication with clients.

Responsibilities

• Follow up on outstanding hospital patient accounts for insurance payments.
• Communicate with insurance companies to resolve unpaid claims.
• Manage and investigate causes of non-payment for hospital claims.

Skills

Bilingual Communication

Customer Service

Detail-oriented

Organizational Skills

Multi-tasking

Excellent Communication

Education

High School Diploma or Equivalent

Job description

Here at Harris, you'll be working as part of 5 different business verticals: Public Sector, Healthcare, Utilities, Insurance, and Private Sector, with over 12,000 employees and more than 100,000 customers located in 200 countries around the globe. We need your help to keep growing and we hope you can become an integral part of the Harris family.

Job Summary:

The Account Follow-up Representative I is responsible for the review and resolution of outstanding insurance balances for hospital patient accounts. The Account Follow-up Representative I is required to learn multiple hospital systems, conduct research, and work basic outstanding insurance claims in pursuit of resolving unpaid claims. The primary goal of an Account Follow-up Representative I is to complete tasks related to the timely resolution of accounts receivable.

Primary Functions:

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 patients' insurance, proration to correct financial class, and notation of patient accounts with steps taken for resolution.
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. Assigned Payor denials and Zero ($0) pay reports worked 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. Responsible for resolving patient accounts with outstanding insurance claims to a zero balance or advancing 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 phone calls, insurance payor web portals, and e-faxing.
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, and initiating coding reviews for account resolution.
11. Complete adjustment requests for Team Lead approval if an adjustment to the outstanding is necessary.
12. Submit requests for claim rebilling when additional information is required, using either a spreadsheet or EHR. Use the hospital's ticketing system to submit claim inquiry requests if additional information or review from the hospital is required.

Job Qualifications:

The qualifications we are looking for are a mixture of work experience and educational background. They are split into Minimum Qualifications (must have) and Additional Qualifications (nice to have) along with soft skills (competencies) needed for the role:

Minimum Qualifications:

1. High School or equivalency diploma required.
2. 5-7 years experience in account follow-up role performing follow-up on hospitals' inpatient and outpatient insurance claims.
3. 5-7 years experience in Customer Service positions.
4. Bilingual (written, verbal, and listening).

Soft Skills:

1. Excellent communication, good judgment, tact, initiative, and resourcefulness.
2. Must be detail-oriented, organized, and have the ability to multi-task.
3. Possess the ability to concentrate for long periods of time.
4. Ability to work individually and/or as part of a team.
5. Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives.
6. Must be flexible with a can-do attitude and the ability to remain professional under high-pressure situations.
7. Demonstrates the ability to learn new systems quickly and develop proficient operating skills within a reasonably short timeframe.
8. Must be able to follow directions and perform work according to department standards independently.
9. Must be emotionally mature and able to function effectively under high-pressure situations.

Interested candidates can share their CV at [e-mail].