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

Trinity Health•Farmington Hills, MI

1d•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 and supports the revenue cycle process. Provides training and guidance to lower-level colleagues and helps resolve billing and follow-up issues. The position reports directly to a Supervisor Billing & Follow-Up. The role documents claims billed, paid, settled, and followed up in appropriate systems; contacts payers and patients about delayed payments; investigates overpayments, underpayments, credit balances, and payment delays; and researches and corrects claim rejections. It also coordinates with hospital departments to clarify billing discrepancies and obtain needed information, routes tasks to appropriate workflows to support timely and accurate reimbursement, and may prepare reports as directed by the supervisor. The position operates in a typical office environment and requires frequent communication with people across locations, including by telephone. The representative must organize changing priorities, manage concurrent tasks, and follow applicable laws, regulations, and Trinity Health policies and procedures. The position is remote. Pay range: $19.5965–$29.3948.

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 health care financial services setting, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service activities.
Proficiency in 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 and perform billing and follow-up activities promptly and accurately.
Ability to work 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 changing work priorities and manage concurrent tasks in a potentially stressful environment with people who have 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 for an assigned PBS location as part of the revenue cycle team.
Document claims billed, paid, settled, and followed up in appropriate systems.
Identify and escalate issues affecting accurate billing and follow-up.
Contact payers directly about 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, and route tasks to appropriate workflows to maximize reimbursement and support 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 delay, and supplying 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.
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.
Maintain working knowledge of applicable laws, regulations, the Integrity and Compliance Program, Code of Conduct, and related policies and procedures.
Perform other duties as needed and assigned by the supervisor.
Demonstrate Trinity Health’s Mission, Vision, and Values in work behaviors, practices, and decisions.