Follow Up and Billing Rep

St. Elizabeth Healthcare•Erlanger, KY

4d•Onsite

About The Position

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.

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.