Billing and Follow-Up Representative-II (Hospital Follow-Up-Medicaid/HMO Payor-MI)- 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. As part of the billing and follow-up team, handles government and non-government accounts, documents claim activity, investigates payment issues, and works to maximize reimbursement and resolve claims accurately and promptly. Provides training and guidance to lower-level colleagues and problem resolution as needed. This remote position reports directly to a Supervisor Billing & Follow-Up. The role requires adherence to applicable laws, regulations, Trinity Health policies, and its Integrity and Compliance Program and Code of Conduct. Colleagues are expected to demonstrate the organization’s Mission, Vision, and Values through honest, ethical, and professional behavior.

Requirements

High school diploma or an Associate's degree in Accounting, Business Administration, or 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; experience may 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 to reduce potential financial loss to patients and the 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 organize work priorities and adapt as they change, and to work on multiple tasks or projects in a potentially stressful environment with people of diverse personalities and work styles.
Ability to comply with Trinity Health policies and procedures.

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 supporting the revenue cycle for an assigned PBS location.
Document claims billed, paid, settled, and followed up 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 appropriate workflows to maximize reimbursement and ensure timely, accurate claim resolution.
Research claim rejections, make corrections, take corrective actions, or refer claims to appropriate colleagues.
Follow up on delayed payments by contacting patients and third-party payers, determining the cause of delays, and supplying additional data as needed.
Prepare special reports as directed by the Supervisor Billing and Follow-Up, such as reports on claims and dollars billed, edited claims, or unprocessed claims.
Assist with training and educating Billing and Follow-Up Representative I colleagues, including upon hire and when new systems, processes, or payers are introduced.
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.