Account Follow-Up Representative I

This is a fully remote position, open to applicants in Arizona, +16 more states.

📋 Description

• Timely follow-up on outstanding hospital patient accounts for insurance payment.

• Verify the status of claim payments, rebill to patient insurance, adjust to the correct financial class, and document the steps taken to resolve issues.

• Manage an average of 40–50 accounts per workday for designated payors.

• Address assigned payor denials and zero-pay reports within 24 hours of their receipt.

• Collect demographic, clinical, medical record, authorization, and insurance information necessary for settling outstanding claims.

• Analyze, communicate, and assist in resolving denial/variance trends and payor issues in collaboration with other teams and departments.

• Identify and prepare simpler claims for reconsiderations and appeals.

• Support leadership in managing assigned accounts receivable (A/R) and resolving outstanding insurance balances within 90 days post-discharge.

• Collaborate closely with third-party payors to address outstanding insurance balances.

• Provide education and training to new hires and support less experienced representatives.

• Investigate patient accounts and navigate them through appropriate workflows.

• Review and recommend account adjustments following payor, company, and client guidelines.

• Complete projects assigned by the team lead or manager to meet client contractual service agreements.

• Work with teams and departments to resolve issues, concerns, and workflows related to projects.

• Maintain the effectiveness of the MEDHOST Quality Management System and adhere to relevant regulatory requirements.

• Attend role-specific education courses, team meetings, and departmental gatherings.

• Submit worked hours accurately by departmental deadlines.

• Stay informed about insurance payors and collection regulations.

• Respond swiftly to emails, calls, voicemails, Microsoft Teams messages, and other correspondence.

• Comply with HIPAA Privacy and Security standards.

• Perform other assigned tasks as needed.

⛳️ Requirements

• High-speed internet access (minimum 300 Mbps download speed) and unlimited data plan.

• Smartphone for Multi-Factor Authentication (MFA) application.

• Understanding of revenue cycle processes affecting insurance reimbursements.

• Familiarity with insurance follow-up processes and fundamental concepts in healthcare reimbursement methodologies.

• Proficient in using telephone systems for both outbound and inbound calls.

• Access to protected health information (PHI) in accordance with departmental assignments and guidelines.

• Competent in performing accurate arithmetic computations.

• Excellent communication skills, sound judgment, tact, initiative, and resourcefulness.

• Must be detail-oriented, organized, and capable of multitasking.

• Ability to concentrate for extended periods.

• Capable of working independently and/or as part of a team.

• Ability to foster supportive relationships with peers, clients, partners, and corporate executives.

• Must exhibit flexibility with a "can-do" attitude and maintain professionalism in high-pressure situations.

• Demonstrated ability to quickly learn new systems and develop proficient operating skills in a short timeframe.

• Comprehension of both oral and written directives.

• High School diploma or equivalent required.

• Minimum of 3 years' experience in a related field.

• Ability to follow directions and perform tasks according to departmental standards independently.

• Must possess emotional maturity and the ability to function effectively under pressure.

• Proficient in Microsoft Office applications (i.e., Word, Excel, PowerPoint, etc.) to complete assigned tasks.

• Customer service-oriented mindset.

🏝️ Benefits

• 3 weeks of vacation and 5 personal days.

• Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment.

• Employee stock ownership and RRSP/401k matching programs.

• Lifestyle rewards.

• Remote work opportunities and more!