The Account Follow-up Representative is responsible for review and resolution of outstanding insurance balances on hospital patient accounts. The Account Follow-up Representative will be required to have flexibility in learning and comprehending complex hospital systems and keen analytical skills to evaluate appropriate next steps to bring aged account receivables to resolution. The Account Follow-up Representative will be responsible to ensure cash recovery goals are met and assigned hospital receivables are appropriately addressed according to company, client, and federal guidelines. The position requires professional Customer interaction and adherence to MEDHOST best practice methodologies.

Follow-up on MEDHOST customer patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patients insurance, proration to correct financial class, and notation of patient accounts with steps taken for resolution
Work an average of 40-50 accounts per day on assigned payor(s)
Work assigned payor(s) zero pay report(s) 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 patients information
Work outstanding accounts to resolution
Basic understanding of Institutional (UB04) and Professional (1500) claim forms
Perform duties and responsibilities in a positive manner that upholds MEDHOST policies and procedures
Responsible for general office duties including but not limited to, filing, scanning, printing, and data entry
Working knowledge of hospital information systems (MEDHOST experience preferred)
Demonstrates the ability to learn new systems quickly and develop proficient operating skills within a reasonably short timeframe
Understand both oral and written directives
Ability to prioritize job responsibilities and manage time effectively for completion of assignments
Accurately perform tasks with a high level of attention to detail
Proficiency with telephone systems for outbound/inbound calls
Perform account research and route accounts through appropriate workflows
Completes timely follow-up on assigned accounts and documents findings in detail
Review and recommend adjustments to accounts in accordance with payor and MEDHOST guidelines
Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies
Applies a thorough understanding/interpretation of Explanation of Benefits (EOB) and Remittance Advices
Understanding of Medicare, Medicaid, Commercial and other Government insurance payors
Use critical thinking skills and payor knowledge to recommend system edits/updates to reduce denials and result in prompt and accurate payment
Effectively answer emails, calls, TEAMS messages, and correspondence from patients, agencies, and facilities.
Participate and complete projects assigned by team lead or manager to improve ongoing operations within the department
Works in partnership with other departments regarding resolution of issues or concerns
Complete assigned LinkedIn learning path within the calendar year
Attend 6 role based education courses within the calendar year
Assist with other assignments as needed
Assist other members of the team as needed
Other duties as assigned

Administrative Duties:
Accurately input/submit worked time by the required departmental deadlines Maintain department documentation
Maintain documentation regarding Customer interaction
Provide training and training documentation in areas of expertise necessary to assist team members and Customers Maintain in-depth knowledge of the MEDHOST core products
Maintain in-depth knowledge of insurance payers and collection regulations
Maintain MEDHOST software applications utilized & industry knowledge through self-study and by attending training classes Attend and participate in team and departmental meetings
Responds to email, TEAMS, and phone communications in a timely manner
Ensure that all HIPAA Privacy and Security requirements and responsibilities are adhered to constantly Books travel in adherence to the company travel policy
All other duties as assigned

Knowledge, Skills, and Abilities:

Knowledge of computer applications or other automated systems, such as excel spreadsheets, word, email, and database software in working assignments. MEDHOST (HMS) knowledge preferred.
Knowledge of hospital billing and revenue cycle terminology
Access protected health information (PHI) in accordance with departmental assignments and guidelines
Skilled in making accurate arithmetic computations
Understand and communicate sufficiently to perform essentials duties of this position
Display excellent communication, good judgment, tact, initiative, and resourcefulness
Proven ability to understand and interpret reason for payments or refunds
Must be detail oriented, organized, and ability to multi-task
Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives
Must be flexible with a can do attitude and have the ability to remain professional under high pressure situations

Training and Experience:
High School or equivalency diploma required
2 years or more experience, where the primary function was in insurance follow-up (recent graduate of Medical Billing and Coding coursework accepted in lieu of experience)
Must be able to follow directions and to perform work according to department standards independently
Sufficient in Microsoft Office applications (i.e., Word, Excel, PowerPoint, etc.) to complete work assigned
Must be emotionally mature and able to function effectively under stress
Customer Service oriented

Other Requirements:
Negative pre-employment drug tests
Criminal and MVR backgrounds meet our company hiring criteria

MEDHOST jobs

Account Follow Up Representative