Billing Control Representative FT Days

Trane Technologies•Detroit, MI

About The Position

Under the direction of the Manager, Patient Accounting, the Billing Control Representative balances computer reports and reviews inpatient accounts for compliance with third-party payors. The representative reviews and corrects computer-generated error reports, contacts appropriate representatives to reconcile insurance coverage, monitors collection activities by patient account collectors and collection agencies, analyzes revenue recovery trends, and performs other assigned patient accounting duties. The role maintains Patient Accounting information-system master files; prepares system-generated reports and researches irregularities; conducts special projects and account-compliance research; monitors payments and reconciles DRG payment discrepancies; and processes corrected billing to maximize reimbursement. It also prepares weekly and month-end financial reports, tracks collection and recovery statistics, follows pending cases through to billable status, monitors bankruptcy cases, and reviews microfiche reports for legibility and completeness. The representative is expected to support DMC values through commitment to quality, community welfare, respect, teamwork, communication, innovation, education, and effective resource use.

Requirements

High school graduate or equivalent.
One to three years of hospital billing or related experience.
Firm understanding of accounts receivable, collection, and third-party payor processes.
Knowledge of basic accounting principles.
Operational computer skills.
Communication skills to interact with payors.
Analytical skills and high visual acuity to work on reports.

Responsibilities

Balance computer reports and review inpatient accounts for compliance with third-party payors.
Review and correct computer-generated error reports and contact appropriate representatives to reconcile insurance coverage.
Monitor collection activities performed by patient account collectors and collection agencies.
Analyze revenue recovery trends.
Maintain and update Patient Accounting information-system master files, including charge, professional, insurance, and billing masters as applicable.
Prepare system-generated reports, make corrections, research irregularities, and compile data for presentation.
Perform special projects and research accounts for compliance with third-party payors.
Monitor payments, reconcile DRG payment discrepancies, and process corrected billing to maximize reimbursement.
Prepare and analyze weekly and month-end financial reports to monitor activity in specified areas.
Maintain statistics on turnover and recovery percentages for outside agencies and departmental Patient Account Collectors.
Follow up on pending medical cases, insurance-coverage reconciliations, and other unbilled accounts until completion and billable status is achieved.
Monitor bankruptcy cases and notify appropriate agencies.
Review microfiche for legibility and verify that all reports are accounted for.
Demonstrate behaviors supportive of DMC's values, including quality, community welfare, respect, involvement, teamwork, communication, innovation, education, and effective resource use.