Account Follow-Up Representative I

Job description

**This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for an Account Follow-Up Representative I based in the United States.** As an Account Follow-Up Representative, you will play an essential role in resolving outstanding hospital insurance claims and supporting accurate, timely healthcare reimbursements. You will investigate unpaid balances, communicate with insurance providers, and coordinate with internal teams to ensure claims progress toward resolution. Working remotely, you will manage a high-volume portfolio of patient accounts while maintaining accuracy, compliance, and excellent service standards. You will contribute to improving revenue cycle performance by identifying claim discrepancies, addressing denials, and following established reimbursement procedures. This role offers the opportunity to develop your healthcare billing expertise while collaborating with experienced professionals across multiple departments. If you are organized, detail-oriented, and motivated by solving problems in a fast-paced environment, this opportunity offers a meaningful way to support healthcare operations. ### Accountabilities - **Manage outstanding insurance claims:** Review and follow up on hospital patient accounts with unpaid insurance balances, verify claim payment status, rebill insurers when necessary, correct financial classifications, and document all actions taken to resolve outstanding balances. - **Meet daily productivity targets:** Process an average of 40–50 assigned accounts per workday while maintaining accuracy, efficiency, and compliance with departmental standards. - **Investigate claim denials and payment discrepancies:** Review payer denial notices and zero-payment reports within 24 hours of receipt, identify issues affecting reimbursement, and prepare straightforward claims for reconsideration or appeal. - **Gather and verify claim information:** Obtain demographic details, clinical documentation, medical records, authorizations, and insurance information required to support payment, ensuring relevant systems are updated accurately. - **Collaborate with insurance providers:** Communicate with third-party payors to clarify claim issues, obtain missing information, and determine the appropriate next steps to resolve outstanding balances. - **Support accounts receivable performance:** Assist team leadership in managing assigned accounts receivable portfolios and work toward resolving outstanding insurance balances within 90 days of patient discharge. - **Identify trends and recommend improvements:** Research recurring denial patterns, payment variances, and payer-related issues, collaborating with other departments to improve workflows and reimbursement outcomes. - **Maintain account accuracy and compliance:** Review and recommend account adjustments in accordance with payer requirements, client guidelines, internal policies, quality management procedures, and applicable regulatory standards. - **Support team development:** Help train new hires, provide guidance to less experienced representatives, and share knowledge of insurance follow-up procedures and account resolution practices. - **Contribute to departmental initiatives:** Participate in special projects, workflow improvements, and assignments from team leaders or managers to support client commitments and operational objectives. - **Manage administrative responsibilities:** Submit work hours by established deadlines, maintain current knowledge of insurance payors and collection regulations, attend required training and meetings, and respond promptly to emails, calls, messages, and other correspondence. - **Embrace AI and innovation:** Demonstrate curiosity and willingness to use AI assistants, copilots, and automation tools to improve research, streamline workflows, and increase productivity while maintaining appropriate security, privacy, and compliance standards. - **Protect confidential information:** Follow all applicable HIPAA privacy and security requirements when accessing, processing, and communicating protected health information (PHI). ## Requirements - **Education and experience:** High school diploma or equivalent required, along with at least 3 years of experience in a related field. - **Healthcare revenue cycle knowledge:** Understanding of revenue cycle processes, insurance follow-up procedures, healthcare reimbursement principles, and the factors affecting claim payment. - **Communication and telephone skills:** Proficiency with inbound and outbound telephone systems, strong verbal and written communication skills, and the ability to interact professionally with insurers, colleagues, clients, and other stakeholders. - **Research and analytical abilities:** Ability to investigate account discrepancies, gather relevant information, perform accurate arithmetic calculations, and determine appropriate actions to resolve outstanding claims. - **Organization and time management:** Strong attention to detail, effective prioritization, and the ability to manage multiple accounts and deadlines while maintaining consistent productivity. - **Problem-solving and judgment:** Demonstrated initiative, tact, resourcefulness, sound judgment, and the ability to remain professional and effective in high-pressure situations. - **Independent and collaborative working style:** Ability to follow instructions, work independently according to departmental standards, and collaborate effectively with colleagues and cross-functional teams. - **Technical proficiency:** Working knowledge of Microsoft Office applications, including Word, Excel, and PowerPoint, as well as the ability to learn new systems and develop proficiency within a reasonable timeframe. - **Customer service orientation:** Commitment to responsive, respectful, and professional communication, with the flexibility and positive attitude needed to address changing priorities. - **Adaptability and continuous learning:** Ability to understand oral and written instructions, maintain industry knowledge through self-study and training, and adapt to new processes, technologies, and business requirements. - **AI readiness:** Willingness to adopt AI-enabled tools and automation technologies in everyday work, using sound judgment to verify outputs and protect confidential information. - **Remote work requirements:** Reliable high-speed internet with a minimum download speed of 300 Mbps and unlimited data, plus a smartphone capable of supporting a multifactor authentication (MFA) application. ## Benefits - **Competitive hourly pay:** $18–$26 per hour, depending on qualifications and experience. - **Full-time employment:** Stable, full-time opportunity in healthcare revenue cycle operations. - **Remote work:** Work from home anywhere in the United States. - **Paid time off:** Three weeks of vacation and five personal days. - **Comprehensive healthcare coverage:** Medical, dental, and vision benefits starting on the first day of employment. - **Retirement and ownership programs:** Employee stock ownership opportunities and 401(k) matching. - **Lifestyle rewards:** Additional lifestyle-related benefits and rewards. - **Learning and development:** Opportunities to strengthen healthcare reimbursement knowledge, develop technical skills, and participate in training and professional development. - **Collaborative work environment:** Work alongside cross-functional teams focused on service quality, operational efficiency, and continuous improvement. - **Technology-enabled workflows:** Opportunities to use modern AI tools and automation technologies to improve efficiency and support problem-solving.