Follow Up and Billing Rep

St. Elizabeth Healthcare•Edgewood, KY

About The Position

Engage with us for your next career opportunity. Right Here. Job Type: Regular Scheduled Hours: 40 💙 Why You’ll Love Working with St. Elizabeth Healthcare At St. Elizabeth Healthcare, every role supports our mission to provide comprehensive and compassionate care to the communities we serve. For more than 160 years, St. Elizabeth Healthcare has been a trusted provider of quality care across Kentucky, Indiana, and Ohio. We’re guided by our mission to improve the health of the communities we serve and by our values of excellence, integrity, compassion, and teamwork. Our associates are the heart of everything we do. 🌟 Benefits That Support You We invest in you — personally and professionally. Enjoy: - Competitive pay and comprehensive health coverage within the first 30 days. - Generous paid time off and flexible work schedules - Retirement savings with employer match - Tuition reimbursement and professional development opportunities - Wellness, mental health, and recognition programs - Career advancement through mentorship and internal mobility Job Summary: This position is responsible for the accurate and timely billing and collection of assigned accounts using computerized patient accounting systems. This position must stay current with workers compensation billing rules, OSHA regulations, workers compensation regulations, and contractual agreements with payers. This position is also responsible and accountable for communication to the leadership team regarding identified issues with charges, orders, invoicing etc. This position is also responsible to work with, train and orient physicians/providers with accurate and appropriate coding of work compensation charges. Demonstrate respect, dignity, kindness and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background. Job Description: Communication/Trending: Trends weekly productivity, Billing WIP, Follow-up WIP and agings. Attends weekly billing staff meetings Identifies payor & billing issues Participates in a positive & constructive manner Addresses and follows up on any client call or concern by next business day. Billing Responsibilities: Reviews bills and related information for accuracy and reasonableness of charges Submits bills to payers electronically if possible, otherwise paper Submits monthly self-pay statements to clients Stays current with third party contractual agreements and regulations to apply requirements for accurate billing and to make recommendations for system changes as needed Maintains zero billing WIP Follow-Up Responsibilities: Calls payers for status on accounts on work list Records appropriately detailed notes in the Systoc system Takes appropriate action to resolve claims, i.e., the rep would proceed to complete any and all steps to have the claim paid. Including and not limited to; re-file claim, send notes, make corrections to the claim information, call employer, call patient, etc. Writes appeal letters Communicates with supervisor at Business Health and at payers Calculates expected reimbursement on accounts if necessary Holds payers responsible to contract terms and fee schedules Completes work list with the activity code, tickle date, phone number Demonstrates ability to work with high volume of outgoing calls associated with collection of accounts Demonstrates adequate, appropriate, and professional levels of communication with insurance company representatives, team members, supervisors, and managers. Establishes relationship with payer contacts Ensures timely turnaround of internal requests (EOB’s, medical records) through effective follow-up Performs due diligence on all collection efforts Ensures expected reimbursement is secured Elevates serious barriers to claim resolution to appropriate management Assists other follow-up reps when necessary, as determined by manager, work with billing staff to identify and resolve billing issues and develop standard billing practices Maintains zero follow-up WIP Performs other duties as assigned. Education, Credentials, Licenses: High school diploma or equivalent Specialized Knowledge: Medical billing experience as acquired in a physician office setting. PC Skills, including Word and Excel. Customer Service Skills Excellent Communication Skills Knowledge of workers compensation and third-party billing rules and regulations Kind and Length of Experience: One-year experience in physician billing and collections or equivalent education FLSA Status: Non-Exempt Right Career. Right Here. If you're looking for the right careers in healthcare, the right place to be is at St. Elizabeth. Join us, and you'll take pride in the level of care we offer our community. St. Elizabeth Healthcare is one of the oldest, largest and most respected medical providers in the Northern Kentucky, Southeastern Indiana and Greater Cincinnati region. Together with St. Elizabeth Physicians, the affiliated multi-specialty physician and advanced practice provider organization, we are transforming healthcare through innovative treatments, cutting-edge technology and a heart for our community. We’re right here, sharing one mission: to improve the health of the people we serve.

Requirements

High school diploma or equivalent
Medical billing experience as acquired in a physician office setting.
PC Skills, including Word and Excel.
Customer Service Skills
Excellent Communication Skills
Knowledge of workers compensation and third-party billing rules and regulations
One-year experience in physician billing and collections or equivalent education

Responsibilities

Trends weekly productivity, Billing WIP, Follow-up WIP and agings.
Attends weekly billing staff meetings
Identifies payor & billing issues
Participates in a positive & constructive manner
Addresses and follows up on any client call or concern by next business day.
Reviews bills and related information for accuracy and reasonableness of charges
Submits bills to payers electronically if possible, otherwise paper
Submits monthly self-pay statements to clients
Stays current with third party contractual agreements and regulations to apply requirements for accurate billing and to make recommendations for system changes as needed
Maintains zero billing WIP
Calls payers for status on accounts on work list
Records appropriately detailed notes in the Systoc system
Takes appropriate action to resolve claims, i.e., the rep would proceed to complete any and all steps to have the claim paid. Including and not limited to; re-file claim, send notes, make corrections to the claim information, call employer, call patient, etc.
Writes appeal letters
Communicates with supervisor at Business Health and at payers
Calculates expected reimbursement on accounts if necessary
Holds payers responsible to contract terms and fee schedules
Completes work list with the activity code, tickle date, phone number
Demonstrates ability to work with high volume of outgoing calls associated with collection of accounts
Demonstrates adequate, appropriate, and professional levels of communication with insurance company representatives, team members, supervisors, and managers.
Establishes relationship with payer contacts
Ensures timely turnaround of internal requests (EOB’s, medical records) through effective follow-up
Performs due diligence on all collection efforts
Ensures expected reimbursement is secured
Elevates serious barriers to claim resolution to appropriate management
Assists other follow-up reps when necessary, as determined by manager, work with billing staff to identify and resolve billing issues and develop standard billing practices
Maintains zero follow-up WIP
Performs other duties as assigned.