Billing and Follow-Up Representative-II (Hospital Medical Billing Follow-up) - PFS (Remote)

Trinity Health•Farmington Hills, MI

3d•$20 - $29•Remote

About The Position

Performs day-to-day billing and follow-up activities within revenue operations for an assigned Patient Business Services (PBS) location. Works as part of a team responsible for billing and following up on government and non-government accounts, and provides training, guidance, and problem resolution to colleagues. The position reports directly to a Supervisor Billing & Follow-Up. The role supports the revenue cycle by documenting claims and payment activity, contacting payers and patients about outstanding payments, resolving claim issues, and coordinating with hospital departments to clarify billing discrepancies and obtain needed information. It may also involve preparing reports and assisting with colleague training. The role requires adherence to applicable laws, regulations, organizational policies, and Trinity Health’s Integrity and Compliance Program and Code of Conduct. The position operates in a typical office environment that is well lit, temperature controlled, and free from hazards. The work involves frequent communication in person and by phone, keyboard use, and extended time looking at a CRT screen. The noise level is low to moderate. The employee must organize changing priorities and work on multiple tasks in an environment that may be stressful and include people with diverse personalities and work styles.

Requirements

High school diploma or an Associate's degree in Accounting, Business Administration, a related field, or an equivalent combination of education and experience.
At least three years of direct 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. Relevant activities include medical claims processing, financial counseling, financial clearance, accounting, or customer service.
Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel.
Excellent verbal and written communication and organizational abilities.
Strong interpersonal skills when dealing 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.
Ability to work 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 as they change, manage multiple tasks or projects concurrently, and adapt to a potentially stressful work environment.
Ability to comply with Trinity Health policies and procedures.
Manual dexterity to operate a keyboard and hearing ability for extensive telephone and in-person communication.

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 as part of the revenue cycle team for an assigned PBS location.
Document claims billed, paid, settled, and followed up in the appropriate systems.
Identify and escalate issues affecting accurate billing and follow-up.
Contact payers directly regarding payments due and review and respond to mail correspondence accurately and promptly.
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 appropriate workflows to maximize reimbursement and ensure timely, accurate claim resolution.
Research claim rejections, 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 reason for delay, and supplying additional information as needed.
Prepare special reports as directed by the Supervisor Billing and Follow-Up, such as reports on claims and dollars billed, edited claims, and unprocessed claims.
Assist with training and educating Billing and Follow-Up Representative I colleagues, including on new systems, processes, or payers.
Provide problem resolution for billing and follow-up issues as needed.
Perform other duties as assigned by the supervisor.
Maintain working knowledge of applicable laws, regulations, compliance requirements, and organizational policies and procedures.
Demonstrate Trinity Health’s Mission, Vision, and Values in work behaviors, practices, and decisions.