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

Trinity Health•Farmington Hills, MI

1d•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 on a team responsible for billing and following up on government and non-government accounts. The position reports directly to the Supervisor Billing and Follow-up and is remote. The role supports the revenue cycle by documenting claims and payment activity, investigating billing and payment issues, and working with payers, patients, hospital departments, and colleagues to resolve claims accurately and promptly. It also requires compliance with applicable laws, regulations, and Trinity Health policies and standards of conduct.

Requirements

High school diploma.
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 healthcare financial services setting; qualifying activities may include medical claims processing, financial counseling, financial clearance, accounting, or customer service. An equivalent combination of education and experience is also accepted.
Basic understanding of Microsoft Office, including Outlook, Word, PowerPoint, and Excel.
Excellent verbal and written communication and organizational abilities.
Strong interpersonal skills for working with internal and external customers.
Accuracy, attention to detail, and time-management skills.
Ability to work independently and perform billing and follow-up activities promptly and accurately.
Comfort operating in a collaborative, shared-leadership environment.
Personal presence characterized by honesty, integrity, and caring, with the ability to inspire and motivate others in support of Trinity Health’s philosophy, mission, vision, goals, and values.
Ability to organize work priorities, adapt to frequent changes, and manage multiple tasks or projects in a potentially stressful environment.
Ability to comply with Trinity Health policies and procedures.
Ability to operate a keyboard and communicate extensively by telephone and in person.

Nice To Haves

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

Responsibilities

Perform daily billing and follow-up activities in support of the revenue cycle for an assigned PBS location.
Document claims billed, paid, settled, and followed up on in appropriate systems.
Identify and escalate issues affecting accurate billing and follow-up.
Contact payers regarding payments due and review and respond to mail correspondence promptly and accurately.
Communicate with hospital departments to clarify billing discrepancies and obtain demographic, clinical, financial, and insurance information.
Investigate overpayments, underpayments, credit balances, and payment delays.
Route tasks to the appropriate workflows to maximize reimbursement and ensure claims are paid or settled accurately and promptly.
Research rejected claims, make corrections, take corrective action, or refer claims to colleagues for resolution.
Follow up on delayed payments by contacting patients and third-party payers, determining the cause of delay, and providing additional information as needed.
Prepare special reports as directed by the Supervisor Billing and Follow-up.
Perform other duties as assigned by the supervisor.
Maintain knowledge of applicable laws, regulations, Trinity Health compliance requirements, and related policies and procedures.
Demonstrate Trinity Health’s Mission, Vision, and Values in work behaviors and decisions.