Payment Integrity Representative

  At HealthFund Solutions, we are an advocate for the uninsured and the underinsured patients and a partner to hospitals and healthcare providers. With decades of experience in the healthcare field, we observed a rising need to help a percentage of the population that continues to grow every day—those living without health insurance. Through sponsorship programs, Medicaid screening and premium monitoring, we empower patients to get the coverage and care they need to get back on their feet.

Reporting to our Payment Integrity Manager, the Payment Representative acts as a liaison between our patients and their insurance companies. Prior experience with insurance technology, medical background, and payment management of accounts.

Responsibilities:

• Interact with Company departments and external vendors 
• Send, receive, and review contracts with external vendors 
• Update Company databases, with extreme attention to detail 
• Work in compliance with banking portals 
• Verify Insurance information on patient account for accuracy and contract compliance
• Assist in making patient insurance premiums payments
• Accurately record payments made in company database per outlined procedures
• Review exception reports
• Actively pursue refunds owed by insurance companies 
• Maintains accurate and organized patient files (both paper and electronic versions)
• Other duties as assigned

Requirements:

• High School Diploma required
• College Degree or some college preferred
• Three (3) to five (5) years of related experience in medical billing or accounting is preferred
• Organized
• Extreme Attention to Detail
• Process Initiative
• Ability to communicate effectively in speaking and writing
• Work effectively with individuals from diverse backgrounds
• Ability to establish and maintain effective working relationships
• Ability and desire to communicate effectively by telephone
• Perform basic operations in Microsoft Office Suite
• General Accounting experience is helpful
• Prior experience in medical insurance invoicing and payment management of accounts is helpful

NOTE: This job description is not intended to be all-inclusive. Employee may perform other duties as required to meet the ongoing needs of the organization.

Please note that as we are vendors to several hospital systems. All onsite hospital positions are required to have the COVID vaccination completed prior to start date. If you choose not to vaccinate, you are required to provide a fully executed medical or religious exemption form prior to your start date. Upon approval of that exemption, you would be required to submit to weekly COVID testing. Be aware, that this policy could change at any time.

We are an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

The successful candidate will be required to complete the Form I-9 and that information will be verified using the E-Verify system. E-Verify is operated by the Department of Homeland Security in partnership with the Social Security Administration to verify employment eligibility.

Any candidate offered a position will be required to pass pre-employment screenings which include a national background check and a 12-panel drug screen. HealthFund Solutions is a Drug -Free Workplace.