Account Follow Up Rep

City of Hope

97d

About The Position

The Account Follow-up Representative (AFR) is responsible for understanding and reconciling various insurance practices, both contracted and non-contracted. The role focuses on maximizing reimbursement and resolving patient or insurance (hospital or physician) account balances by employing comprehensive follow-up tactics in the following areas: Insurance Account Follow-up (hospital or physician): Handle the reimbursement and resolution processes for insurance accounts. Self-pay Account Follow-up: Concentrate on collecting the patient responsibility portion left by insurance using assistance programs and tools. This area also includes managing the inbound call center. Administration of Financial Programs: Support patients with medical balances through Financial Assistance, Co-pay Assistance, Free Drug programs, Drug Replacement, etc.

Requirements

• High school diploma or equivalent, or passed proficiency exam.
• At least 3 years of accounts receivable (A/R) experience in a hospital or physician healthcare setting, including insurance and self-pay healthcare collections/billing, and insurance verification.
• Demonstrated analytical capability and experience with account reconciliation and balancing.
• Strong knowledge of medical terminology, ICD-9 codes, CPT/HCPCs codes.
• Familiarity with Medicare Bad Debt laws and requirements, and Fair Debt Collection laws.
• Understanding of insurance contracts and reimbursement methodologies.
• Ability to interpret Explanation of Benefits (EOBs) and navigate patient insurance policies.
• Knowledge of collection agency work, probate courts, and bankruptcy laws and regulations.
• Advanced written and verbal communication skills.
• Proficiency in technology, especially in spreadsheet management and trend analysis.
• Excellent organizational skills, with the ability to manage multiple priorities and responsibilities.
• Exceptional customer service skills.

Responsibilities

• Handle the reimbursement and resolution processes for insurance accounts.
• Concentrate on collecting the patient responsibility portion left by insurance using assistance programs and tools.
• Manage the inbound call center.
• Support patients with medical balances through Financial Assistance, Co-pay Assistance, Free Drug programs, Drug Replacement, etc.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees