Remote) Account Follow-Up Representative

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/hrAI & 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.

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

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

High Speed Internet access (minimum 300 Mbps download speed) and unlimited data Smart phone for Multi Factor Authentication (MFA) application

Knowledge of revenue cycle processes impacting insurance reimbursements

Knowledge of insurance follow-up processes with understanding of the fundamental concepts in healthcare reimbursement…