MEDHOST, a division of Harris; is seeking an Account Follow-up Representative II who will be 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.
This remote role welcomes candidates anywhere in the US.
Wage:
$18-$26/hr
AI & Innovation Mindset
We are committed to leveraging emerging technologies to improve how we work, serve our customers, and drive business outcomes. The successful candidate will demonstrate curiosity and a willingness to actively adopt and leverage AI tools to improve workflows, solve problems, and increase efficiency. Candidates should be comfortable using AI enabled technologies, including copilots, chat based AI assistants, and automation tools, as part of their everyday work while maintaining appropriate judgment, security, and compliance standards.
What your impact will be:
Primary Duties and Responsibilities (Other Duties May Be Assigned)
- 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
Other Requirements
- High Speed Internet access (minimum 300 Mbps download speed) and unlimited data
- Smart phone for Multi Factor Authentication (MFA) application
What we are looking for:
- 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
- High School or equivalent diploma required
- 3+ years' experience in related 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
What we can offer:
- 3 weeks’ 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 and more!
About MEDHOST:
MEDHOST, founded in 1984 and headquartered in Franklin, Tennessee, is a leading provider of healthcare information technology solutions. Serving over 1,000 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:
Harris is a leading provider of mission critical software to the public sector in North America. As a wholly owned subsidiary of Constellation Software Inc. (“CSI”, symbol CSU on the TSX), Harris has become the cornerstone for CSI’s investment in utility, local government, school districts, public safety, and healthcare software verticals. Our success has been realized through investments in our proprietary software and market expertise. This focus, combined with acquiring businesses that build upon or complement our offerings, has helped drive our success. Harris will continue to growth through reinvestment – both in the people and products that we offer and making investments in acquiring new businesses.
#LI-remote
High school diploma or equivalent; 3+ years related experience; high-speed internet (300 Mbps) and smartphone for MFA; proficiency in Microsoft Office; knowledge of revenue cycle and insurance follow-up; HIPAA compliance.
Key Responsibilities
- resolving insurance claims
- researching patient accounts
- communicating with payors
Skills & Tools
Microsoft Office, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Teams
Job Details
- Category: Customer Service
- Seniority: Mid Level
- Commitment: Full Time
- Workplace: Remote — Tennessee or Wisconsin or Arizona or Washington or Virginia or Utah or Texas or Minnesota or Massachusetts or Pennsylvania or Oregon or Illinois or Georgia or Florida or North Carolina or Missouri or Colorado or California
- Salary: USD 37,440 – 54,080 / year
- Languages: English
Benefits
- 401k matching
- Generous paid time off
- Retirement plan
About MEDHOST
A healthcare information technology provider offering EHR, financial management, and patient engagement solutions. — Industry: Information Technology