Rep, Account Follow Up
Cancer Treatment Centers of America® (CTCA®) takes a unique and integrative approach to cancer care. Our patient-centered care model is founded on a commitment to personalized medicine, tailoring a combination of treatments to the needs of each individual patient. At the same time, we support patients’ quality of life by offering therapies designed to help them manage the side effects of treatment, addressing their physical, spiritual and emotional needs, so they are better able to stay on their treatment regimens and get back to life. At the core of our whole-person approach is what we call the Mother Standard® of care, so named because it requires that we treat our patients, and one another, like we would want our loved ones to be treated. This innovative approach has earned our hospitals a Best Place to Work distinction and numerous accreditations. Each of us has a stake in the successful outcomes of every patient we treat. Job Description:
Cancer care is all we do
Hope in healing
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.
Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us. Visit: Jobs.cancercenter.com to begin your journey.
We win together
Visit: Jobs.cancercenter.com to begin your journey.