Demonstrates expertise in revenue cycle processes and insurance follow-up methodologies, with a strong focus on timely resolution of patient accounts and compliance with regulatory requirements. Proficient in communication and collaboration with teams to address denial trends and enhance operational workflows.

Highest-signal resume keywords

Revenue Cycle ProcessesInsurance Follow-UpClaim Payment VerificationMicrosoft Office ProficiencyCustomer Service Orientation

About the role

Key responsibilities & impact

Timely follow-up on hospital patient accounts outstanding for insurance payment
Verify claim payment status, rebill to patient insurance, prorate to correct financial class, and document resolution steps
Work an average of 40–50 accounts per workday for assigned payors
Work assigned payor denials and zero-pay reports within 24 hours of receipt
Gather demographic, clinical, medical record, authorization, and insurance information needed to pay outstanding claims
Analyze, communicate, and help resolve denial/variance trends and payor issues with other teams and departments
Identify and prepare less complex claims for reconsiderations and appeals
Assist leadership in managing assigned A/R and resolving outstanding insurance balances at 90 days post-discharge
Work closely with third-party payors to resolve outstanding insurance balances
Deliver education and training for new hires and assist less experienced representatives
Research patient accounts and route them through appropriate workflows
Review and recommend account adjustments according to payor, company, and client guidelines
Complete projects assigned by team lead or manager to fulfill client contractual service agreements
Partner with teams and departments to resolve project issues, concerns, and workflows
Maintain MEDHOST Quality Management System effectiveness and comply with applicable regulatory requirements
Attend role-based education courses, team meetings, and departmental meetings
Accurately submit worked time by departmental deadlines
Maintain knowledge of insurance payors and collection regulations
Respond promptly to emails, calls, voicemails, Microsoft Teams messages, and correspondence
Adhere to HIPAA Privacy and Security requirements
Perform other assigned duties

Requirements

What you’ll need

High Speed Internet access (minimum 300 Mbps download speed) and unlimited data
Smart phone for Multi Factor Authentication (MFA) application
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

Benefits

Comp & perks

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!

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claim Payment VerificationRevenue Cycle ProcessesInsurance Follow-Up ProcessesArithmetic ComputationsDemographic Information GatheringDenial AnalysisAccount AdjustmentsProject ManagementHealthcare Reimbursement MethodologiesMulti-Factor Authentication (MFA)

Soft Skills

Excellent CommunicationDetail OrientedOrganizational SkillsAbility to Multi-TaskEmotional Maturity

Tools & Technologies

Telephone SystemsMicrosoft OfficeMEDHOST Quality Management System

Industry Keywords

HIPAA ComplianceProtected Health Information (PHI)Insurance PayorsClient Contractual Service AgreementsHigh Pressure Situations