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:

The Account Follow-up Rep (AFR) is responsible for the reimbursement and/or resolution of patient account balances and is accountable for complete follow-up tactics working accounts to exhaustion maximizing reimbursement. This role performs account management and analysis; as well as complete, timely, and accurate follow up of patient or insurance (hospital or physician) account balances with the objective of optimizing insurance reimbursement and ensuring that our patients receive the best CTCA has to offer in account management. An Account Follow-up Rep may be responsible for working account balances in any of the following areas:

• Insurance Account Follow-up (hospital or physician), which may include a focus on claims denied by insurance carriers or paid incorrectly (underpaid).
• Self-pay Account Follow-up focusing on the collection of the patient responsibility portion left by insurance leveraging assistance programs and tools. This area includes the inbound call center.
• Administration of financial programs supporting the patient with medical balances such as Financial Assistance, Co-pay Assistance, Free Drug, Drug Replacement, etc.

The AFR interacts with, and leverages, external and internal sources to overcome barriers, problem solve, and ultimately resolve account balances. This includes patients, caregivers and family members, site stakeholders, contracted and non-contracted insurance, third party payers, and employers as necessary. They are expected to review and determine appropriate actions on assigned patient accounts at a minimum of every 45 days or as the collection process requires.

This role is accountable for understanding and reconciling insurance practices (contracted/non-contracted).

Confirming that a claim/account has been verified, billed, and paid correctly through analysis of payments and adjustments. The AFR will take the appropriate action to resolve claims that are not paid correctly as a result of denials or underpayment. This position is also responsible for ensuring that account statements are accurate and timely and with the appropriate statement message; that patients have an understanding of their balances and are appropriately engaged in appeals with insurance. The AFR provides assistance options to support patients with their financial responsibility where appropriate.

Leveraging all available account follow-up and analysis options the AFR may ultimately determine that account balances are uncollectable. This can be through bad debt adjustment, month end review with the site CFO, or leveraging patient financial assistance programs.

The AFR is considered an agent acting on behalf of the patient, as well as CTCA, and therefore must exemplify the highest in CTCA standards to ensure a consistently positive patient experience. Serves as a direct point of contact for CTCA patients and regularly fields patient inquiries and complaints. The Account Follow-up Rep reports directly to the Account Follow-up Supervisor.

City of Hope is an equal opportunity employer. To learn more about our commitment to diversity, equity, and inclusion, please click here.

To learn more about our comprehensive benefits, click here:Benefits Information

City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location.