The Account Follow-up Representative is responsible for managing and resolving hospital patient accounts with outstanding insurance claims. This includes verifying claim payment statuses, communicating with insurance companies, and performing necessary follow-up actions to ensure claims are processed. The role demands effective management of patient accounts and the ability to resolve outstanding balances through various methods.
- 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.
Similar Jobs
Be an Early Applicant
The Account Follow-up Representative manages and resolves outstanding patient accounts related to insurance payments. Their role includes verifying claim statuses, communicating with insurance companies, and ensuring patient accounts are accurately processed to achieve zero balances. This includes working with denial reports and various communication methods to resolve claims effectively.
Be an Early Applicant
The Account Follow-up Representative is responsible for managing outstanding hospital patient accounts for insurance payments. This includes verifying claim payments, communicating with insurance companies, resolving outstanding balances, and performing follow-ups on unpaid claims. The role involves a high volume of account management using various methods of communication and research to achieve resolution for patients.
Be an Early Applicant
The Account Follow-up Representative is responsible for managing and resolving outstanding patient accounts related to insurance payments. This role involves following up on claims, investigating non-payments, and communicating with insurance companies to ensure timely resolution of payment issues.
What you need to know about the Pune Tech Scene
Once a far-out concept, AI is now a tangible force reshaping industries and economies worldwide. While its adoption will automate some roles, AI has created more jobs than it has displaced, with an expected 97 million new roles to be created in the coming years. This is especially true in cities like Pune, which is emerging as a hub for companies eager to leverage this technology to develop solutions that simplify and improve lives in sectors such as education, healthcare, finance, e-commerce and more.
