You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

The Account Service Representative II – Claim Follow-Up Representative is responsible for managing claim follow-up activities to ensure timely reimbursement for professional services. This role includes investigating and resolving unpaid or denied claims, working payer correspondence, and collaborating with internal departments and payers to secure proper claim resolution. The representative will work within the Epic system to monitor accounts receivable and take necessary actions to reduce aged AR.

Key Responsibilities

• Conduct timely and thorough follow-up on outstanding professional billing claims using Epic workqueues.
• Research and resolve denied, delayed, or unpaid claims by communicating with payers via phone, portal, or written correspondence.
• Review payer responses and denial codes to determine appropriate action for claim resolution.
• Coordinate with coding, registration, and clinical departments to correct claim errors and resubmit when appropriate.
• Document all activities and communications clearly in the Epic system to maintain accurate account records.
• Identify and escalate trends or payer issues to management for resolution and payer intervention.
• Maintain knowledge of payer-specific guidelines and billing regulations.
• Meet or exceed productivity and quality metrics established by the department.
• Assist with training and mentoring of new staff as needed.

Skills

• Strong problem-solving and analytical skills.
• Excellent verbal and written communication skills.
• Ability to navigate payer websites and systems for claim status and resolution.
• Proficiency in Microsoft Office applications (Excel, Word, Outlook).
• Ability to manage time effectively and work independently in a fast-paced environment.
• Understanding of HIPAA and patient confidentiality requirements.

Education

• High school diploma or GED required.
• Associate’s or Bachelor’s degree in healthcare, business, or related field preferred.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*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 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.

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.