Billing and Follow-Up Representative-II (Hospital Medical Billing Follow-up - Commerical Payors) - PFS (Remote)

Billing And Follow-Up Representative

Position Purpose : Work Remote Position (Pay Range : $19.2123-$28.8184)

Performs the day-to-day billing and follow-up activities within the revenue operations for an assigned Patient Business Services (PBS) location. Serves as a member of the billing and follow-up team assigned to a PBS location responsible for billing and follow-up of government and non-government accounts. Provides training and guidance to lower level colleagues and provide problem resolution as needed. This position reports directly to a Supervisor Billing & Follow-Up.

Essential Functions :

• Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions
• Performs daily activities as part of the billing and follow-up team in support of the revenue cycle process for an assigned PBS location.
• Documents claims billed, paid, settled, and follow-up in appropriate system(s).
• Identifies and escalates issues affecting accurate billing and follow-up activities.
• Adheres to proactive practices which includes contacting the payer directly for payment due on accounts and reviewing and responding to all mail correspondence in a timely and accurate manner.
• Communicates with appropriate hospital departments to clarify billing discrepancies, and obtain demographic, clinical, financial, and insurance information.
• Performs all follow-up functions which includes the investigation of overpayments, underpayments, credit balances and payment delays.
• Tasks will be routed to the correct workflows with the objective of maximizing reimbursement for services rendered and ensuring claims are paid or settled in a timely and accurate manner.
• Researches claim rejections, make corrections, take corrective actions, and / or refer claims to appropriate colleagues to ensure timely and accurate claim resolution.
• Proactively follow up on delayed payments by contacting patients and third-party payers and determining the cause for delay and supplying additional data as required.
• May prepare special reports as directed by the Supervisor Billing and Follow-Up to document follow-up services, e.g., number of claims and dollars billed, claims edited, claims unprocessed, etc.
• Assists in the training and education of Billing and Follow-up Representative I colleagues upon hire and ongoing, and as new systems, processes or payers are created.
• Provides problem resolution to billing and follow-up issues as needed.
• Other duties as needed and assigned by the supervisor.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health's Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Minimum Qualifications :

Physical and Mental Requirements and Working Conditions :

This position operates in a typical office environment. The area is well lit, temperature controlled and free from hazards. Incumbent communicates frequently, in person and over the phone, with people in all locations on product support issues. Manual dexterity is needed in order to operate a keyboard. Hearing is needed for extensive telephone and in person communication. The incumbent is subject to eyestrain due to the many hours spent looking at a CRT screen. The noise level is low to moderate. Must be able to set and organize own work priorities and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks / projects in an environment that may be stressful with individuals having diverse personalities and work styles. Must possess the ability to comply with Trinity Health policies and procedures.

Our Commitment : Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. EOE including disability / veteran