Billing and Follow-up Representative-II (Hospital Billing Follow-up - Medicaid Payor) - PFS (Remote)

Job Title

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 :

• 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.
• 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 :

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.