Job Description

Employment Status:
Full time
Job Function:
Business Support
401806 PA & Appeals - Clerical
Shift Hours / Days:
Mon - Fri Days
Hours / Pay Period:

Account Follow Up Representative – Out of Network Reimbursement Specialist


We Fight Cancer: Care That Never Quits®

Cancer Treatment Centers of America® (CTCA®) delivers an extraordinary patient experience we call Patient Empowered Care ®. We deliver state-of-the-art, high quality care through an integrative model where a team of experts puts patients at the center of their own care. Every day, you will help patients win the fight against cancer. Every day is challenging and rewarding beyond your imagination.


A Culture of Teamwork, Empowerment & Development

CTCA provides Stakeholders with exceptional support and easy access to a wide range of tools and resources they need to bring the best of themselves, every day. Our benefits, wellness, and compensation programs lead the market. We provide extensive training and career development opportunities that encourage professional and personal growth—it is a point of pride. We empower our Stakeholders to deliver the highest standard of care, which we call the Mother Standard®.


Job Summary/Purpose:


The Out of Network Account Follow Up Rep manages the CTCA patient financial experience as the analytical and relationship arm of the Patient Accounts lifecycle.  This role performs account management and analysis; as well as complete, timely, and accurate follow up on both hospital and physician account balances with the objective of optimizing reimbursement and ensuring that our patients receive the best CTCA has to offer in account management.  This is role specializes in out of network reimbursement and requires the ability to negotiate directly with payers for additional reimbursement on accounts that pay less than expected.  In addition to standard account follow up the out of network follow up representative will file post payment appeals and support the prompt pay and single case agreement process.


The Account Follow Up Rep 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. The Account Follow Up Rep function is directly responsible for approximately 30% of ongoing cash flow and therefore, is expected to review and determine appropriate management actions on assigned patient accounts at a minimum of every 45 days or as the collection process to resolution requires. Through the account follow-up and analysis process the Account Follow Up Rep will recommend final resolution for account balances that cannot be collected.  This can be through adjustment, month end review with the site CFO, or collection/litigation.


The Account Follow Up Rep must be able to utilize a holistic approach to managing a patient account from the time it is received through to resolution. The Account Follow Up Rep 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. Must be capable of understanding and reconciling that an account has been verified, billed, and paid correctly. Must be capable of analyzing account payments and adjustments. Ensures account statements are accurate and timely and with the appropriate statement message.  Fields patient inquiries and complaints on a daily basis. The Account Follow Up Rep reports directly to the Account Follow Up Supervisor.

Minimum Qualifications:

  • Must have a high school diploma/equivalent or passed proficiency exam, with strong analytical skills.

  • Associates degree in related field is desirable.

  • BA/BS is preferred.

  • Must have a minimum of 3 years or greater A/R experience in a hospital or physician healthcare setting which will include insurance and self-pay healthcare collections/billing as well as insurance verification experience.


    The Best Place to Work


    We call ourselves Stakeholders because we all have a stake in the care and success of every patient. Today, CTCA Stakeholders deliver healing and hope to patients fighting complex and advanced cancer in Atlanta, GA, Chicago, IL, Philadelphia, PA, Phoenix, AZ and Tulsa, OK.  Each of our hospitals earned a Best Place to Work distinction and receives numerous accreditations that celebrate our culture of clinical quality, innovation, high performance and wellness.


    Beyond The Resume, What We Look For


    We select people with talent—people who thrive in an environment of continuous improvement. We are creative and resourceful problem solvers. We are inventors and innovators. As a CTCA Stakeholder, you make the difference in the life of a patient.


    Do you see yourself working with a passionate team in a dynamic, high growth environment?  Visit   to begin your journey.