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.
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