Billing and Follow-up Representative – Hospital Medical Billing Follow-up, Commercial Payors
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Job Description
Remote medical billing follow-up representative supporting Trinity Health’s hospital revenue cycle. Resolving commercial payer claims, payment delays, rejections, and billing discrepancies.
Responsibilities:
- Perform daily billing and follow-up activities within the revenue cycle for an assigned Patient Business Services location
- Bill and follow up on government and non-government accounts
- Document claims billed, paid, settled, and follow-up activities in appropriate systems
- Identify and escalate issues affecting accurate billing and follow-up
- Contact payers directly regarding payment due on accounts
- Review and respond to mail correspondence accurately and promptly
- Communicate with hospital departments to clarify billing discrepancies and obtain demographic, clinical, financial, and insurance information
- Investigate overpayments, underpayments, credit balances, and payment delays
- Route tasks to appropriate workflows to maximize reimbursement and ensure timely, accurate claim settlement
- Research claim rejections, make corrections, take corrective actions, and refer claims for resolution
- Follow up on delayed payments with patients and third-party payers
- Prepare special reports as directed by the Supervisor Billing and Follow-Up
- Maintain knowledge of applicable laws, regulations, Trinity Health compliance programs, policies, and procedures
- Perform other duties as assigned
Requirements:
- High School diploma and successful completion of the Trinity Health Trainee program with related productivity and quality standards, or at least one year of experience and relevant knowledge of revenue cycle functions and systems in a hospital or clinic, health insurance company, managed care organization, or other health care financial service setting
- Experience performing medical claims processing, financial counseling, financial clearance, accounting, or customer service activities, or equivalent combination of education and experience
- Experience in a complex, multi-site environment preferred
- Basic understanding of Microsoft Office, including Outlook, Word, PowerPoint, and Excel
- Completion of regulatory/mandatory certifications and skills validation competencies preferred
- Excellent verbal and written communication and organizational abilities
- Strong interpersonal skills
- Accuracy, attention to detail, and time management skills
- Ability to work independently
- Ability to perform billing and follow-up activities promptly and accurately
- Comfort operating in a collaborative, shared leadership environment
- Ability to comply with Trinity Health policies and procedures
- Ability to set and organize work priorities and adapt to frequent changes
- Ability to work concurrently on varied tasks/projects in a potentially stressful environment
Benefits:
- Remote work position
- Equal Opportunity Employer commitment
- Mission- and values-based workplace
- Collaborative, shared leadership environment
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