Billing Follow Up Representative I

American Addiction Centers • Charlotte, NC

1d • $21 - $31 • Onsite

About The Position

This position supports moderately complex processes related to billing, coding, and reimbursement. The representative will actively follow up with insurance carriers on open insurance claims and must have an understanding of contractual relationships. The role supports complete and timely revenue collection from patients and third-party payers through accurate data entry and/or correction of patient, charge, and insurance information into the system. The representative will also identify and report patterns and trends to relevant departments for potential delays or denials in reimbursement and verify daily electronic claim submissions.

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.

Nice To Haves

• Knowledge of medical terminology, coding, terminology (CPT, ICD-10, HCPC) and insurance/reimbursement practices.
• Ability to communicate well with people to obtain basic information (via telephone or in person).

Responsibilities

• Independently review accounts and apply billing follow-up knowledge required for all insurance payors to ensure proper and maximum reimbursement.
• Use multiple systems to resolve outstanding claims according to compliance guidelines.
• Perform pre-billing, billing, and follow-up activity on open insurance claims, utilizing revenue cycle knowledge (e.g., CPT, ICD-10, HCPCS, NDC, revenue codes, and medical terminology).
• Obtain necessary documentation from various resources.
• Communicate timely and accurately with internal teams and external customers (e.g., third-party payors, auditors, other entities) and act as a liaison with external third-party representatives to validate and correct information.
• Comprehend incoming insurance correspondence and respond appropriately.
• Identify and bring patterns/trends to leadership's attention regarding coding and compliance, contracting, claim form edits/errors, and credentialing for any potential delay/denial of reimbursement.
• Obtain and stay updated on insurance payer updates/changes, single case agreements, and assist management with recommendations for implementation of any edits/alerts.
• Accurately enter and/or update patient/insurance information into the patient accounting system.
• Appeal claims to ensure contracted amounts are received from third-party payors.
• Comply with 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 of recommendations regarding handling of observed unusual/unreasonable/inaccurate account information, approval needed to write off balances according to corporate policy, and issues outside the normal scope of activity and responsibility.

Benefits

• Comprehensive suite of Total Rewards
• Benefits and well-being programs
• Competitive compensation
• Generous retirement offerings
• Programs that invest in your career development
• 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

What This Job Offers

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