Account Follow-Up Representative I

Summary

MEDHOST is a healthcare information technology company that provides solutions for healthcare organizations. The Account Follow-Up Representative I reviews and resolves outstanding insurance balances for hospital patient accounts by researching claims, communicating with payors, documenting findings, and completing accounts receivable workflows.

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 30-40 patient accounts per workday for assigned payor(s)
• Assigned Payor denials and Zero ($0) pay reports worked within 48 hours of receipt
• Communicate effectively with insurance companies for payment of outstanding insurance balances
• Understanding of the next steps needed to reach a resolution of outstanding insurance balance
• Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows
• Completes timely follow-up on assigned accounts, documents research findings in detail and notate next steps towards resolution
• Review and recommend adjustments on accounts in accordance with payor 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
• Ability to prioritize job responsibilities and manage time effectively for completion of assignments
• Complete role-based education and assigned learning courses by the designated deadlines
• 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
• Assist with other assignments as needed
• Performs other duties as assigned
• Accurately input/submit worked time by the required departmental deadlines
• Maintain basic knowledge of insurance payors and collection regulations
• Maintain basic 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

Skills

• 1-3 years of hands-on experience with standard office software and computer applications
• Proficiency in the Microsoft Office Suite (Word, Excel, Outlook) for creating documents, managing data in spreadsheets, and professional email correspondence
• Experience using database software for accurate data entry and retrieval
• Demonstrated ability to manage inbound and outbound calls professionally using multi-line telephone systems or VoIP software
• Strong numerical skills with a proven ability to perform accurate arithmetic computations
• High School or equivalent diploma required
• 1+ years' experience in related field of customer service and in a medical field
• Excellent verbal and written communication skills, with the ability to convey information clearly and professionally to diverse audiences
• Meticulous attention to detail to ensure accuracy and quality in all work
• Strong organizational and time-management skills, with a proven ability to prioritize and manage multiple tasks simultaneously in a dynamic environment
• A proactive and resourceful approach to challenges, demonstrating initiative to find effective solutions
• A resilient and flexible mindset, maintaining professionalism and a positive, "can-do" attitude, especially when faced with high-pressure situations
• A versatile work style, comfortable working autonomously on assigned tasks and collaborating effectively within a team to achieve common goals
• Proven ability to build supportive and positive professional relationships with peers, clients, and partners
• Understanding of the importance of handling sensitive and confidential information, such as Protected Health Information (PHI), with strict adherence to privacy protocols
• A quick learner with a demonstrated aptitude for mastering new software, systems, and processes efficiently

Qualifications

Must Haves

• 1-3 years of hands-on experience with standard office software and computer applications
• Proficiency in the Microsoft Office Suite (Word, Excel, Outlook) for creating documents, managing data in spreadsheets, and professional email correspondence
• Experience using database software for accurate data entry and retrieval
• Demonstrated ability to manage inbound and outbound calls professionally using multi-line telephone systems or VoIP software
• Strong numerical skills with a proven ability to perform accurate arithmetic computations
• High School or equivalent diploma required
• 1+ years' experience in related field of customer service and in a medical field
• Excellent verbal and written communication skills, with the ability to convey information clearly and professionally to diverse audiences
• Meticulous attention to detail to ensure accuracy and quality in all work
• Strong organizational and time-management skills, with a proven ability to prioritize and manage multiple tasks simultaneously in a dynamic environment
• A proactive and resourceful approach to challenges, demonstrating initiative to find effective solutions
• A resilient and flexible mindset, maintaining professionalism and a positive, "can-do" attitude, especially when faced with high-pressure situations
• A versatile work style, comfortable working autonomously on assigned tasks and collaborating effectively within a team to achieve common goals
• Proven ability to build supportive and positive professional relationships with peers, clients, and partners
• Understanding of the importance of handling sensitive and confidential information, such as Protected Health Information (PHI), with strict adherence to privacy protocols
• A quick learner with a demonstrated aptitude for mastering new software, systems, and processes efficiently

Benefits

• 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
• A casual work environment that offers comfort while providing superior service to our customers
• A comprehensive benefit package
• We empower our employees to make a difference
• We have an award-winning culture
• We offer opportunity to learn
• We have fun!