Remote Quality Management System Jobs in Georgia

MEDHOST, a division of Harris; is seeking an Account Follow-up Representative I who is responsible for reviewing and resolving outstanding insurance balances for hospital patient accounts.

The Account Follow-up Representative I is required to learn multiple hospital systems, conduct research, and work basic outstanding insurance claims in pursuit of resolving unpaid claims. The primary goal of an Account Follow-up Representative I is to complete tasks related to the timely resolution of accounts receivable.

This remote role welcomes candidates anywhere in the US. Preference will be given to candidates who can work in CST or EST timezone.

Wage: $18 - $26/hr

AI & Innovation Mindset

We are committed to leveraging emerging technologies to improve how we work, serve our customers, and drive business outcomes. The successful candidate will demonstrate curiosity and a willingness to actively adopt and leverage AI tools to improve workflows, solve problems, and increase efficiency. Candidates should be comfortable using AI enabled technologies, including copilots, chat based AI assistants, and automation tools, as part of their everyday work while maintaining appropriate judgment, security, and compliance standards.

What your impact will be

• 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 of patient accounts with steps taken for resolution.
• Work an average of 30-40 patient accounts per workday for assigned payor(s).
• 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 the next steps needed to reach a resolution of outstanding insurance balance.
• Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows.
• Completes timely follow-up on assigned accounts, documents research findings in detail and notate next steps towards resolution.
• Review and recommend adjustments on accounts in accordance with payor and client guidelines.
• Participate in and complete projects assigned by team lead or manager to fulfill clients' contractual agreement of services.
• Work in partnership with other teams/departments regarding resolution of project issues, concerns, and workflows.
• Ability to prioritize job responsibilities and manage time effectively for completion of assignments.
• Complete role-based education and assigned learning courses by the designated deadlines.
• Maintain the effectiveness and implementation of the MEDHOST Quality Management System and meet applicable regulatory requirements as needed.
• Responsible for QMS procedures listed in QMS Procedure Crosswalk found in QMS Manual as applicable.
• Performs other duties as assigned.

Administrative Duties

• Accurately input/submit worked time by the required departmental deadlines
• Maintain basic knowledge of insurance payors and collection regulations
• Maintain basic industry knowledge through self-study and by attending training classes
• Attend and participate in team and departmental meetings
• Effectively responds to emails, telephone calls, voicemails, Microsoft Teams messages, and correspondence from patients, agencies, and facilities in a timely manner
• Adherence to all HIPAA Privacy and Security requirements and responsibilities
• Perform duties and responsibilities in a positive manner that upholds company policies and procedures

What we are looking for:

• Knowledge of computer applications or other automated systems, such as excel spreadsheets, word, email, and data base software in working assignments.
• 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 oral and written directives.
• High School or equivalent diploma required.
• 1+ years' experience in related field (recent graduate of Medical Billing and Coding coursework accepted in lieu of experience).
• 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.
• Customer Service oriented.
• High Speed Internet access (minimum 300 Mbps download speed) and unlimited data.
• Smart phone for Multi Factor Authentication (MFA) application.

What we can offer:

• 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!

About MEDHOST:

MEDHOST, founded in 1984 and headquartered in Franklin, Tennessee, is a leading provider of healthcare information technology solutions. Serving over 1,000 healthcare facilities nationwide, MEDHOST offers a comprehensive suite of products, including electronic health records (EHR), financial management systems, and patient engagement platforms. Their mission is to empower healthcare organizations to enhance patient care and improve business operations through innovative, user-friendly solutions. In January 2024, MEDHOST was acquired by N. Harris Computer Corporation, further strengthening its position in the healthcare IT industry.

About Harris:

Harris is a leading provider of mission critical software to the public sector in North America. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals. Our success has been realized through investments in our proprietary software and market expertise. This focus, combined with acquiring businesses that build upon or complement our offerings, has helped drive our success. Harris will continue to growth through reinvestment - both in the people and products that we offer and making investments in acquiring new businesses.

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