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Account Manager / Representative
Oceanport, NJ

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Medix

Appeals Follow Up Rep

Job Description

Please do not apply unless you are located in New York, New Jersey or Pennsylvania. Applicants outside of these states will NOT be considered. Patient Account Representative (Hospital Appeals & Denials) Fully Remote | Contract-to-Hire Opportunity | Monday-Friday We are seeking an experienced Patient Account Representative to join a healthcare revenue cycle team focused on hospital insurance appeals and denial resolution . In this role, you'll work directly with insurance carriers to resolve denied claims, recover revenue, and ensure accounts are accurately processed from start to finish. This is an excellent opportunity for someone with hospital appeals experience who enjoys problem-solving, working independently, and making a direct impact on the organization's financial success. Responsibilities Review, investigate, and resolve denied or underpaid hospital insurance claims. Submit and follow up on appeals for denials, including no authorization and other payer-related issues. Research account discrepancies and correct billing errors to facilitate timely payment. Contact insurance companies and navigate payer portals to obtain claim status and resolve outstanding balances. Prioritize accounts to maximize collections while minimizing resolution time. Identify trends causing payment delays and recommend process improvements. Maintain accurate documentation of all account activity. Collaborate with revenue cycle teammates to ensure timely account resolution. Meet established productivity and quality goals. Maintain compliance with HIPAA, payer guidelines, and revenue cycle best practices. Required Qualifications Hospital appeals and denial follow-up experience Experience appealing no authorization denials Comfortable following up directly with insurance payers Experience navigating payer websites and insurance portals Proficiency with Microsoft Excel Strong analytical and problem-solving skills Excellent communication and organizational abilities Preferred Qualifications EPIC experience Previous hospital revenue cycle or patient accounts experience Schedule Monday-Friday Choose one of the following schedules (EST): 8:00 AM
  • 4:00 PM 8:30 AM
  • 4:30 PM 9:00 AM
  • 5:00 PM First two weeks of training are primarily 9:00 AM
  • 5:00 PM EST (schedule flexibility available with advance communication).
Work Environment 100% Remote Equipment provided
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA). This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.