Account Follow-up Representative

This role is a professional service position. 
The Account Follow-up Representative is responsible for review and resolution of outstanding insurance balances for hospital patient accounts. The Account Follow-up Representative is required to learn multiple hospital systems, conduct research, and work basic & complex patient accounts with outstanding insurance claims in pursuit of resolving unpaid claims. The primary goal of an Account Follow-up Representative is to complete tasks related to timely resolution of unpaid insurance claims.

Primary 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 within patient accounts providing steps taken to resolve outstanding insurance balance on account.

· Work an average of 30-40 patient accounts per workday for assigned payor(s)

· Manages an average of 30-40 patient accounts per day, focusing on denial and zero-pay reporting.

· 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 next steps needed to reach resolution of outstanding insurance balance

· Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows

· Responsible for resolving patient accounts with outstanding insurance claims to a zero balance or advancing them to the patient responsibility financial class.

· Performs account follow-up on unpaid or partially paid insurance claims for hospital services.

· Contacts insurance payors through various methods, including telephone calls, Insurance payor web portals, E-faxing, email

· Investigates the cause of non-payment towards outstanding hospital claims and takes appropriate actions such as: Requesting insurance companies to process claims, requesting cash posting review for corrections, initiating coding reviews for account resolution, contacting patient for insurance information

· Completes adjustment requests for Team Lead approval if an adjustment to the outstanding balance 

· Submits requests for claim rebilling when additional information is required, using either a shared spreadsheet or the EHR system. Utilizes MEDTEAM’s ticketing system to submit claim inquiry requests if additional information or review from the hospital is required.

Minimum Qualifications:

· High School or equivalency diploma required

· 2 years’ experience in account follow-up role performing follow-up on hospitals’ inpatient and outpatient insurance claims   

Soft Skills:

· 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

· Must be able to follow directions and to perform work according to department standards independently

· Must be