Billing Follow Up Representative I

Advocate Health and Hospitals Corporation•Charlotte, NC

13h•Remote

About The Position

This is a full-time remote position within the Enterprise Revenue Cycle - Government Billing Operations department. The role involves independently reviewing accounts, applying billing follow-up knowledge for all insurance payors to ensure proper and maximum reimbursement. The representative will use multiple systems to resolve outstanding claims according to compliance guidelines, perform pre-billing/billing and follow-up activity on open insurance claims, and obtain necessary documentation from various resources. Key responsibilities include communicating effectively with internal teams and external customers, comprehending and responding to insurance correspondence, identifying trends in coding and compliance, staying updated on payer changes, and appealing claims to ensure contracted amounts are received. The role also requires maintaining Key Performance Indicators (KPIs), compiling information for referrals, maintaining clear documentation, understanding Advocate Aurora Health policies, and demonstrating proficiency in software systems. The position requires referring unusual account information or write-off recommendations to a supervisor.

Requirements

High School Diploma or General Education Degree (GED)
Typically requires 1 year of related experience in medical/billing reimbursement environment, or equivalent combination of education and experience.
Must perform within the scope of departmental guidelines for productivity and quality standards.
Works independently with limited supervision.
Accountable and evaluated to organization behaviors of excellence
Basic keyboarding proficiency.
Must be able to operate computer and software systems in use at Advocate Aurora Health.
Able to operate a copy machine, facsimile machine, telephone/voicemail.
Ability to read, write, speak and understand English proficiently.
Ability to read and interpret documents such as explanation of benefits (EOB), operating instructions and procedure manuals.
Ability to communicate well with people to obtain basic information (via telephone or in person).

Nice To Haves

Knowledge of medical terminology, coding, terminology (CPT, ICD-10, HCPC) and insurance/reimbursement practices.

Responsibilities

Independently review accounts and apply billing follow up knowledge required for all insurance payors to insure proper and maximum reimbursement.
Use multiple systems to resolve outstanding claims according to compliance guidelines.
Perform prebilling/billing and follow up activity on open insurance claims exercising revenue cycle knowledge (ie;CPT,ICD-10 and HCPCS, NDC, revenue codes and medical terminology).
Obtain necessary documentation from various resources.
Timely and accurately communicate with internal teams and external customers (ie; third party payors, auditors, other entity) and acts as a liaison with external third party representatives to validate and correct information.
Comprehend incoming insurance correspondence and responds appropriately.
Identify and bring patterns/trends to leaderships attention re:coding and compliance, contracting, claim form edits/errors and credentialing for any potential in delay/denial of reimbursement.
Obtain and keep abreast with insurance payer updates/changes, single case agreements and assists management with recommendations for implementation of any edits/alerts.
Accurately enter and/or update patient/insurance information into patient accounting system.
Appeal claims to assure contracted amount is received from third party payors.
Comply and maintain KPI (Key Performance Indicators) for assigned payers within standards established by department and insurance guidelines.
Compile information for referral of accounts to internal/external partners as needed.
Compile and maintain clear, accurate, on-line documentation of all activity relating to billing and follow up efforts for each account, utilizing established guidelines.
Read and understand all Advocate Aurora Health policies and departmental collections policies and procedures.
Demonstrate proficiency in proper use of the software systems employed by AAH.
Refer to the supervisor for approval or final disposition such as: recommendations regarding handling of observed unusual/unreasonable/inaccurate account information, approval needed to write off balance’s according to corporate policy, and issues outside normal scope of activity and responsibility.

Benefits

Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program