Patient & Insurance Account Resolution Specialist

Job Description

Job Description

***First 90 Days 100% On-Site*** Hybrid Following - 3 Days in Office, 2 Days Remote

Join Our High-Energy Healthcare Call Center Team!

At Revco Solutions we provide exceptional customer service to the patients we service. As a leading healthcare call center, we are seeking highly motivated individuals to join our high-energy call center team. If you are passionate about helping others, thrive in a fast-paced environment, and are committed to delivering outstanding customer service, we want you to be part of our team!

As a Patient Account Specialist, you will play a vital role in assisting the patients we serve by ensuring they receive the support and guidance they need. You will assist the patient with understanding their account and then work with the patient on resolving their balance.

Revco has a performance-based incentive plan, that includes a monthly bonus, as well as a hybrid in office/work from home opportunity.

Pay: $20/hr

Other Benefits Include:

• Medical, Dental, Vision, Life and Disability Coverage
• 401(k) Savings Plan with Company Match
• Paid Time Off (PTO)
• Paid Holidays
• Monthly Bonus Plan
• Hybrid opportunities

As a valued team member your responsibilities will include:

• Answering inbound calls from patients and addressing any inquiries, concerns, or requests with empathy and professionalism.
• Assisting patients with insurance inquiries, claims, and billing matters.
• Providing information about medical procedures, services, and general healthcare inquiries.
• Documenting patient interactions and updating relevant systems according to established guidelines.

POST-CLEARANCE ASSIGNMENT — GOVERNMENT INSURANCE FOLLOW-UP

Following successful completion of the required government background and clearance process, the Specialist will transition to the Government Insurance Follow-Up team.

Responsibilities will include:

• Conduct detailed analysis and follow-up on outstanding government insurance claims to support timely and accurate resolution in accordance with payer guidelines.
• Communicate with insurance carriers, patients, and other appropriate parties to investigate and resolve outstanding accounts.
• Research and resolve claim denials, rejections, underpayments, and payment delays.
• Initiate appropriate billing corrections, appeals, resubmissions, and follow-up activities.
• Prepare and submit required claim documentation, which may include EOBs, itemized statements, medical records, and other supporting documentation.
• Respond to payer and patient inquiries regarding outstanding or delinquent claims.
• Utilize payer portals, Electronic Health Records (EHR), patient accounting systems, and other available technology to investigate claim status and manage follow-up activities.
• Accurately document account activity, communications, claim status, follow-up actions, and resolutions.
• Identify billing or claim issues requiring corrective action or escalation.
• Recognize trends in denials, underpayments, or payment delays and communicate findings that may support process improvements.
• Maintain compliance with privacy requirements, payer guidelines, government requirements, client requirements, and company policies.
• Organize and prioritize daily account inventory in a fast-paced, high-volume environment.
• Consistently meet or exceed established productivity, quality, documentation, and account-resolution standards.
• Participate in special projects and additional assignments as requested by management.

To excel in this role, you should possess the following qualifications:

• Previous healthcare collections, medical billing, patient account resolution, insurance follow-up, claims, call center, or healthcare customer service experience preferred.
• Previous experience working with commercial, third-party, Medicare, Medicaid, or other government insurance claims is preferred.
• Experience investigating unpaid or underpaid medical claims is a plus.
• Direct insurance follow-up experience is not required for associates who demonstrate the aptitude and ability to successfully complete required training 

Requirements:

• High school diploma or equivalent.
• Must be a United States citizen.
• Must possess and be able to provide a valid REAL ID-compliant state-issued driver's license or identification card as primary identification for the required background process.
• Must be willing and able to complete required fingerprinting.
• Must successfully complete all required background investigation and identity-verification processes including going to your local VA office to complete the background investigation process.
• Must be eligible to obtain and maintain any government-required credential, including a Personal Identity Verification (PIV) card.
• Must promptly provide requested documentation and information necessary to complete the background and clearance process.
• The background and clearance process may take up to five months.

So, if you are ready to make a difference and join our industry leading team please apply today!