Account Follow Up Rep

Account Follow Up Rep About City of Hope, City of Hope's mission is to make hope a reality for all touched by cancer and diabetes. Founded in 1913, City of Hope has grown into one of the largest and most advanced cancer research and treatment organizations in the U.S., and one of the leading research centers for diabetes and other life-threatening illnesses. City of Hope research has been the basis for numerous breakthrough cancer medicines, as well as human synthetic insulin and monoclonal antibodies. With an independent, National Cancer Institute-designated comprehensive cancer center that is ranked top 5 in the nation for cancer care by U.S. News & World Report at its core, City of Hope’s uniquely integrated model spans cancer care, research and development, academics and training, and a broad philanthropy program that powers its work. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and cancer treatment centers and outpatient facilities in the Atlanta, Chicago and Phoenix areas. The successful candidate: Account Follow-up Representative (AFR) Job Overview: 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.

Minimum Job Qualifications:

• Education: High school diploma or equivalent, or passed proficiency exam.
• Experience: 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.
• Knowledge, Skills, and Abilities:
• 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.

City of Hope is an equal opportunity employer. City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location. Apply tot his job Apply To this Job