Billing and Follow-up Representative-I (Hospital Medical Billing Follow-up - Blue Cross Payor - Iowa) - PFS (Remote)

Trinity Health•Farmington Hills, MI

3d•$17 - $26•Remote

About The Position

Performs day-to-day billing and follow-up activities within the revenue operations of an assigned Patient Business Services (PBS) location. Serves as a member of the billing and follow-up team responsible for billing and following up on government and non-government accounts. The position reports directly to the Supervisor Billing and Follow-up. This is a remote position focused on hospital medical billing follow-up for the Blue Cross payor in Iowa. The representative supports revenue cycle activities by documenting claims, contacting payers and patients about payment delays, addressing correspondence, researching claim rejections, and coordinating with hospital departments to resolve billing discrepancies. The role also investigates overpayments, underpayments, credit balances, and payment delays, and routes work to appropriate workflows to maximize reimbursement and ensure timely, accurate claim resolution. The position requires a high school diploma and at least one year of relevant experience or an equivalent combination of education and experience. Candidates should have basic Microsoft Office skills, strong communication and organizational abilities, attention to detail, time management skills, and the ability to work independently and collaboratively. The position operates in a typical office environment and involves extensive use of a keyboard, computer screen, and telephone.

Requirements

High school diploma and at least one year of experience and relevant knowledge of revenue cycle functions and systems in a hospital or clinic, health insurance company, managed care organization, or other health care financial service setting; or an equivalent combination of education and experience.
Relevant experience may include medical claims processing, financial counseling, financial clearance, accounting, or customer service activities.
Basic understanding of Microsoft Office, including Outlook, Word, PowerPoint, and Excel.
Excellent verbal and written communication and organizational abilities.
Strong interpersonal skills for dealing with internal and external customers.
Accuracy, attention to detail, and time management skills.
Ability to work independently.
Ability to perform billing and follow-up activities promptly and accurately to reduce potential financial loss to the patient and the Ministry Organization.
Comfort operating in a collaborative, shared leadership environment.
Honesty, integrity, caring, and the ability to inspire and motivate others in support of Trinity Health’s philosophy, mission, vision, goals, and values.
Ability to set and organize work priorities and adapt as priorities change frequently.
Ability to work concurrently on a variety of tasks or projects in a potentially stressful environment with people with diverse personalities and work styles.
Ability to comply with Trinity Health policies and procedures.
Manual dexterity to operate a keyboard, hearing ability for extensive telephone and in-person communication, and ability to work for many hours looking at a computer screen.

Nice To Haves

Experience in a complex, multi-site environment.
Completion of regulatory or mandatory certifications and skills validation competencies.

Responsibilities

Perform daily activities as part of the billing and follow-up team in support of the revenue cycle process.
Document claims billed, paid, settled, and followed up on in appropriate systems.
Identify and escalate issues affecting accurate billing and follow-up activities.
Contact payers directly regarding payments due and review and respond to mail correspondence in a timely and accurate manner.
Communicate with hospital departments to clarify billing discrepancies and obtain demographic, clinical, financial, and insurance information.
Investigate overpayments, underpayments, credit balances, and payment delays, routing tasks to appropriate workflows to maximize reimbursement and ensure timely, accurate claim payment or settlement.
Research claim rejections, make corrections, take corrective actions, and refer claims to appropriate colleagues to ensure timely and accurate resolution.
Follow up proactively on delayed payments by contacting patients and third-party payers, determining the cause of delays, and providing additional data as required.
Prepare special reports as directed by the Supervisor Billing and Follow-up, such as reports on claims and dollars billed, claims edited, and claims unprocessed.
Perform other duties as needed and assigned by the supervisor.
Maintain working knowledge of applicable laws, regulations, and Trinity Health policies, procedures, Integrity and Compliance Program, and Code of Conduct.
Demonstrate Trinity Health’s Mission, Vision, and Values in behaviors, practices, and decisions.