Account Follow-Up Representative I

Harris Computer•Remote - Missouri, MO

About The Position

The Account Follow-Up Representative I follows up on hospital patient accounts with outstanding insurance balances. The representative verifies claim payment status, rebills insurance, prorates accounts to the correct financial class, documents actions and research findings, and routes accounts through appropriate workflows toward resolution. Assigned payor denials and zero-payment reports must be addressed within 48 hours of receipt, and the role typically handles an average of 30–40 patient accounts per workday. The position also involves communicating with insurance companies, recommending account adjustments in accordance with payor and client guidelines, participating in assigned projects, and collaborating with other teams and departments. The representative completes role-based education and assigned learning by their deadlines, supports the effectiveness and implementation of the MEDHOST Quality Management System, and meets applicable regulatory requirements. Administrative duties include accurately submitting worked time by departmental deadlines, maintaining basic knowledge of insurance payors, collection regulations, and the industry, attending training and meetings, responding to communications in a timely manner, and adhering to HIPAA privacy and security requirements and company policies and procedures. Other assignments and duties may be assigned as needed.

Requirements

Ability to prioritize job responsibilities and manage time effectively to complete assignments.
Basic knowledge of insurance payors and collection regulations.
Basic industry knowledge maintained through self-study and training.
Adherence to HIPAA Privacy and Security requirements and responsibilities.

Responsibilities

Follow up timely on hospital patient accounts outstanding for insurance payment, including verifying claim payment status, rebilling insurance, prorating to the correct financial class, and documenting steps taken.
Work an average of 30–40 patient accounts per workday for assigned payors.
Work assigned payor denials and zero-payment reports within 48 hours of receipt.
Communicate effectively with insurance companies to obtain payment of outstanding insurance balances.
Determine the next steps needed to resolve outstanding insurance balances.
Research patient accounts with outstanding insurance balances and route them through appropriate workflows.
Complete timely follow-up on assigned accounts, document research findings in detail, and note next steps toward resolution.
Review and recommend account adjustments in accordance with payor and client guidelines.
Participate in and complete projects assigned by a team lead or manager to fulfill clients’ contractual service agreements.
Work with other teams and departments to resolve project issues, concerns, and workflow matters.
Prioritize job responsibilities and manage time to complete assignments.
Complete role-based education and assigned learning courses by designated deadlines.
Maintain the effectiveness and implementation of the MEDHOST Quality Management System and meet applicable regulatory requirements.
Perform applicable responsibilities listed in the QMS Procedure Crosswalk in the QMS Manual.
Accurately input or submit worked time by departmental deadlines.
Maintain basic knowledge of insurance payors and collection regulations, and maintain basic industry knowledge through self-study and training.
Attend and participate in team and departmental meetings.
Respond in a timely manner to emails, telephone calls, voicemails, Microsoft Teams messages, and correspondence from patients, agencies, and facilities.
Adhere to HIPAA Privacy and Security requirements and responsibilities and uphold company policies and procedures.
Assist with other assignments and perform other duties as assigned.