Billing Follow Up Representative I

Advocate Health • Rome, GA

2d • $21 - $31

About The Position

The Billing Follow Up Representative I independently reviews accounts and applies billing follow-up knowledge for insurance payors to support proper and maximum reimbursement. The role uses multiple systems to resolve outstanding claims in accordance with compliance guidelines and performs prebilling, billing, and follow-up activities on open insurance claims. It obtains documentation from relevant resources, communicates with internal teams and external customers, and serves as a liaison with third-party representatives to validate and correct information.

The representative reviews and responds to insurance correspondence, identifies patterns and trends for leadership, stays informed about payer updates and changes, and assists management with recommendations for edits and alerts. The position updates patient and insurance information, appeals claims, maintains performance indicators for assigned payers, and documents billing and follow-up activity. It follows Advocate Health policies and departmental procedures and refers certain unusual account issues, write-offs, and matters outside its normal scope to a supervisor for approval or final disposition.

Requirements

• High school diploma or GED.
• Typically, one year of related experience in a medical or billing reimbursement environment, or an equivalent combination of education and experience.
• Perform within departmental productivity and quality standards.
• Work independently with limited supervision.
• Basic keyboarding proficiency.
• Ability to operate computers and software systems used at Advocate Health.
• Ability to operate a copy machine, facsimile machine, and telephone or voicemail.
• Proficient ability to read, write, speak, and understand English.
• Ability to read and interpret documents such as explanations of benefits, operating instructions, and procedure manuals.
• Ability to communicate effectively with people to obtain basic information by telephone or in person.

Nice To Haves

• Knowledge of medical terminology, coding terminology (CPT, ICD-10, HCPCS), and insurance or reimbursement practices.

Responsibilities

• Independently review accounts and apply billing follow-up knowledge across insurance payors to support proper and maximum reimbursement.
• Use multiple systems to resolve outstanding claims in accordance with compliance guidelines.
• Perform prebilling, billing, and follow-up activity on open insurance claims, using revenue cycle knowledge and obtaining necessary documentation.
• Communicate accurately and promptly with internal teams and external customers, and liaise with third-party representatives to validate and correct information.
• Review incoming insurance correspondence and respond appropriately.
• Identify and bring patterns and trends involving coding, compliance, contracting, claim form edits or errors, and credentialing to leadership’s attention.
• Keep abreast of insurance payer updates and changes, single case agreements, and assist management with recommendations for implementing edits or alerts.
• Accurately enter or update patient and insurance information in the patient accounting system.
• Appeal claims to ensure contracted amounts are received from third-party payors.
• Meet KPI standards for assigned payers established by the department and insurance guidelines.
• Compile information for referring accounts to internal or external partners as needed.
• Maintain clear and accurate online documentation of billing and follow-up efforts for each account in accordance with established guidelines.
• Read and understand Advocate Health and departmental collections policies and procedures, and demonstrate proficiency with the software systems used by Advocate Health.
• Refer unusual, unreasonable, or inaccurate account information, write-off approvals, and matters outside normal duties to a supervisor.

Benefits

• Paid time off programs.
• Medical, dental, vision, life, and short- and long-term disability benefits.
• Flexible Spending Accounts for eligible health care and dependent care expenses.
• Adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match and other financial wellness programs.
• Educational Assistance Program.
• Competitive compensation, with potential premium pay and incentive pay for select positions, and the opportunity for annual performance-based increases.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED