About The Position

The Third-Party Billing and Follow Up Representative facilitates billing and collection processes for outstanding accounts receivable. The role analyzes claims for compliant and accurate coding and charging, reviews records to confirm demographic and billing information is current, and recommends improvements to billing and collection practices to reduce reimbursement timeframes and improve payment accuracy. It also processes legal requests for information and confirms appropriate authorizations are on file. The representative communicates with patients, internal and external contacts, third-party administrators, attorneys, vendors, and insurance payers about billing, collections, and claim resolution. The position handles correspondence and phone inquiries, documents claims-related conversations and actions, follows up on accounts, files timely claim reconsiderations or reviews with supporting documentation, updates account systems, and performs balance transfers. The role monitors queues and productivity, prepares weekly productivity reports, and works with departments and team members to resolve claims and workflow issues. The position maintains compliance with applicable billing and collection requirements, including CMS and HIPAA, uses hospital software and systems according to policy, and completes annual education requirements. It may also perform special projects and other assigned duties. The position is based at 600 Holiday Plaza Dr, Matteson, Illinois, and is scheduled from 8:00 a.m. to 4:00 p.m. It reports to the System Supervisor of Third-Party Billing and Collections.

Requirements

  • High school diploma or GED; documentation or proof is required.
  • At least one year of experience in healthcare billing.
  • Knowledge of billing hierarchy levels and order of facilitation.
  • Knowledge of compliance and regulations for billing and collection practices established by local and federal government and other governing agencies.
  • Knowledge of hospital billing and collection processes.
  • Knowledge of Microsoft Office Suite.
  • Knowledge of a hospital revenue cycle system.
  • Excellent verbal and written communication skills for communicating with staff at all levels and a diverse patient population.
  • Strong interpersonal and customer service skills.
  • Good phone and email etiquette and timely responses by phone and electronically.
  • Good computer and typing skills to support thorough phone-call documentation.
  • Analytical, problem-solving, critical-thinking, and conflict-resolution skills.
  • Attention to detail, accuracy, and precision.
  • Ability to prioritize, plan, and organize projects and tasks.
  • Ability to multitask and meet deadlines in a fast-paced and stressful environment.
  • Ability to follow department policies and standards and use best practices.
  • Ability to maintain a professional demeanor and composure when challenged.
  • Ability to work independently and as a member of a multidisciplinary team.
  • Ability to perform accurate and reliable mathematical calculations.
  • Ability to see and hear clearly, including with correction.
  • Ability to comply with hospital and department safety requirements.

Nice To Haves

  • At least one year of hospital third-party billing and account follow-up experience within a multi-hospital system.
  • Bilingual English/Spanish or English/Polish.

Responsibilities

  • Facilitate billing and collection processes for outstanding accounts receivable.
  • Communicate with internal and external contacts about primary, secondary, and tertiary billing, collection, and claim resolution, including Medicare and other government and non-government accounts.
  • Monitor daily customer service, quality, and productivity queues and alert management to high call-volume patterns.
  • Handle billing correspondence and phone inquiries from patients, third-party administrators, attorneys, vendors, and insurance payers.
  • Document conversations and actions related to claims inquiries, reviews, and reconsiderations to support and streamline follow-up.
  • Analyze claims for compliant and accurate coding and charging, and verify demographic and billing information.
  • Resolve claim or billing concerns and escalate issues to management when appropriate.
  • Develop working relationships with patients, third-party administrators, attorneys, vendors, and other insurance payers.
  • Follow up on accounts to work toward a zero balance.
  • File timely claim reconsiderations or reviews with supporting documentation and coordinate with departments to obtain information needed to resolve claims.
  • Use software and hospital systems in accordance with hospital policies and procedures.
  • Update account systems, including financial class, eligibility status, payer contact information, and rebills.
  • Communicate workflow-relevant changes and updates to team members.
  • Perform balance transfers.
  • Prepare weekly productivity reports for management and recommend improvements to billing and collection practices.
  • Process legal requests for information and ensure proper authorization is on file.
  • Maintain compliance with applicable billing and collection practices and regulations, including CMS and HIPAA requirements.
  • Complete annual education requirements.
  • Perform special projects and other duties as assigned.
  • Adhere to hospital and department safety requirements, including applicable PPE, hand hygiene, and work-area safety procedures.

Benefits

  • Medical, dental, and vision coverage.
  • Basic term life insurance.
  • Pension plan.
  • Deferred compensation program.
  • Paid holidays, vacation, and sick time.
  • May qualify for the Public Service Loan Forgiveness Program (PSLF).
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