Billing Follow Up Representative I

Advocate Health • Charlotte, NC

1d • $21 - $31 • Remote

About The Position

The Billing Follow Up Representative I reviews accounts and follows up on open insurance claims to support proper and maximum reimbursement. The role uses multiple systems to resolve outstanding claims in accordance with compliance guidelines, applies revenue cycle knowledge, obtains documentation, updates patient and insurance information, and appeals claims as needed.

The representative communicates with internal teams and external customers, including third-party payors, auditors, and other entities. They interpret insurance correspondence, monitor payer updates, identify trends that may affect reimbursement, and maintain timely, accurate documentation of account activity. The position works independently within departmental standards and refers specified unusual account issues, write-offs, and matters outside its normal scope to a supervisor for approval or disposition.

This is a full-time, fully remote position with a schedule of 7:00 a.m. to 3:30 p.m. and 40 hours per week. Candidates must live in one of the states listed in the posting.

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 guidelines.
• Work independently with limited supervision.
• Basic keyboarding proficiency.
• Ability to operate computers and software systems used at Advocate Aurora Health.
• Ability to operate a copy machine, facsimile machine, telephone, and voicemail.
• Ability to read, write, speak, and understand English proficiently.
• 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.
• Accountability to organizational behaviors of excellence.

Nice To Haves

• Knowledge of medical terminology, coding terminology such as CPT, ICD-10, and HCPC, and insurance or reimbursement practices.

Responsibilities

• Independently review accounts and use billing follow-up knowledge for insurance payors to support 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 using revenue cycle knowledge, including medical terminology and coding references.
• Obtain necessary documentation from various resources.
• Communicate timely and accurately with internal teams and external customers, and liaise with external third-party representatives to validate and correct information.
• Interpret incoming insurance correspondence and respond appropriately.
• Identify and bring patterns and trends involving coding, compliance, contracting, claim edits or errors, and credentialing to leadership’s attention when they may delay or prevent reimbursement.
• Keep abreast of insurance payer updates and changes and single case agreements, and assist management with recommendations for implementing edits or alerts.
• Enter and update patient and insurance information in the patient accounting system.
• Appeal claims to help ensure contracted amounts are received from third-party payors.
• Meet key performance indicators for assigned payers within departmental and insurance standards.
• Compile information for account referrals to internal or external partners as needed.
• Maintain clear and accurate online documentation of billing and follow-up activity for each account using established guidelines.
• Read and understand Advocate Aurora Health and departmental collections policies and procedures, and demonstrate proficiency with the organization’s software systems.
• Refer specified unusual or inaccurate account matters, balance write-offs requiring corporate-policy approval, and issues outside the role’s normal scope 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, incentive pay for select positions, and annual performance-based increases.

What This Job Offers

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