Patient & Insurance Account Resolution Specialist

REVCO SOLUTIONS INC; North Carolina; Hybrid; USD 23,000 - 32,000; Full time

Benefits offered by this job

Medical/Dental/Vision/Disability

401(k) with company match

PTO

Paid Holidays

Monthly Bonus

Hybrid work

Job summary

Revco Solutions Inc. in North Carolina is seeking a Patient Account Specialist to help patients understand their accounts and resolve balances. The role begins with on-site work and transitions to a 3-day in-office / 2-day remote hybrid schedule after the first 90 days.

You will handle inbound patient calls, assist with insurance inquiries, claims, and billing matters, and provide information on medical procedures. Accurate documentation and privacy compliance are essential to success.

Qualifications

• High school diploma or equivalent.
• Proficient in basic computer applications and quick to learn new software.
• Empathy, compassion, and a genuine desire to help others.
• Strong attention to detail.

Responsibilities

• Answer inbound calls from patients with empathy and professionalism.
• Assist patients with insurance inquiries, claims, and billing matters.
• Provide information about medical procedures, services, and general healthcare inquiries.
• Document patient interactions and update relevant systems according to guidelines.
• Conduct government insurance follow-up and resolve denials, delays, or underpayments.

Skills

Excellent communication

Strong problem-solving

Multitasking and typing

Education

High school diploma or equivalent

Job description

Description

***First 90 Days 100% On-Site*** Hybrid Following - 3 Days in Office, 2 Days Remote

Join Our High-Energy Healthcare Call Center Team!

At Revco Solutions we provide exceptional customer service to the patients we service. As a leading healthcare call center, we are seeking highly motivated individuals to join our high-energy call center team. If you are passionate about helping others, thrive in a fast-paced environment, and are committed to delivering outstanding customer service, we want you to be part of our team!

As a Patient Account Specialist, you will play a vital role in assisting the patients we serve by ensuring they receive the support and guidance they need. You will assist the patient with understanding their account and then work with the patient on resolving their balance.

Revco has a performance-based incentive plan, that includes a monthly bonus, as well as a hybrid in office/work from home opportunity.

Pay: $20/hr

Other Benefits Include:

• Medical, Dental, Vision, Life and Disability Coverage
• 401(k) Savings Plan with Company Match
• Paid Time Off (PTO)
• Paid Holidays
• Monthly Bonus Plan
• Hybrid opportunities

As a valued team member your responsibilities will include:

• Answering inbound calls from patients and addressing any inquiries, concerns, or requests with empathy and professionalism.
• Assisting patients with insurance inquiries, claims, and billing matters.
• Providing information about medical procedures, services, and general healthcare inquiries.
• Documenting patient interactions and updating relevant systems according to established guidelines.

POST-CLEARANCE ASSIGNMENT — GOVERNMENT INSURANCE FOLLOW-UP

Following successful completion of the required government background and clearance process, the Specialist will transition to the Government Insurance Follow-Up team.

Responsibilities will include:

• Conduct detailed analysis and follow-up on outstanding government insurance claims to support timely and accurate resolution in accordance with payer guidelines.
• Communicate with insurance carriers, patients, and other appropriate parties to investigate and resolve outstanding accounts.
• Research and resolve claim denials, rejections, underpayments, and payment delays.
• Initiate appropriate billing corrections, appeals, resubmissions, and follow-up activities.
• Prepare and submit required claim documentation, which may include EOBs, itemized statements, medical records, and other supporting documentation.
• Respond to payer and patient inquiries regarding outstanding or delinquent claims.
• Utilize payer portals, Electronic Health Records (EHR), patient accounting systems, and other available technology to investigate claim status and manage follow-up activities.
• Accurately document account activity, communications, claim status, follow-up actions, and resolutions.
• Identify billing or claim issues requiring corrective action or escalation.
• Recognize trends in denials, underpayments, or payment delays and communicate findings that may support process improvements.
• Maintain compliance with privacy requirements, payer guidelines, government requirements, client requirements, and company policies.
• Organize and prioritize daily account inventory in a fast-paced, high-volume environment.
• Consistently meet or exceed established productivity, quality, documentation, and account-resolution standards.
• Participate in special projects and additional assignments as requested by management.

To excel in this role, you should possess the following qualifications:

• Excellent communication skills, both verbal and written, with a compassionate and patient-centered approach.
• Strong problem-solving skills and the ability to handle challenging situations with empathy and professionalism.
• Ability to multitask, navigate computer systems efficiently, and type accurately.

Requirements:

• High school diploma or equivalent.
• Proficient in basic computer applications and the ability to learn new software quickly.
• Empathy, compassion, and a genuine desire to help others.
• Strong attention to detail.