Billing Control Representative - Ambulatory

Embark on a rewarding career with DMC Receiving Hospital . If you are a compassionate healthcare professional eager to contribute to patient care, this is your opportunity where your skills make a difference every day. Join us in delivering exceptional healthcare with a personal touch.

Benefits Statement

At Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off (PTO)
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.

Note: Eligibility for benefits may vary by location and is determined by employment status

Summary Description

Under the direction of the Manager, Patient Accounting, balances computer reports; reviews all in-patient accounts for compliance to third party payors; reviews and corrects computer-generated error reports; contacts appropriate representative to reconcile insurance coverage (i.e., unverified child on insurance coverage); monitors collection activities of patient account collectors as well as collection agencies; analyzes revenue recovery trends; performs other patient accounting duties assigned.

1. Maintains and updates Information System master files related to Patient Accounting (charge master and billing).
2. Prepares system generated reports, (i.e., daily edit, DRG, etc.), makes corrections and researches irregularities as necessary. Compiles data for presentation.
3. Performs special projects and researches accounts for compliance to third party payors.
4. Monitors payments, reconciles DRG payment discrepancies, processes corrected billing to maximize reimbursement.
5. Prepares and analyses weekly and month end financial reports to monitor activity in specified areas.
6. Maintains statistics on turnover and percentage of recovery by outside agencies and Patient Account Collectors within the department.
7. Performs follow-up activity on pending cases to include medical cases, reconciliation of insurance coverage and other unbilled accounts until completion and billable status is achieved.
8. May maintain information system master files related to Patient Accounting System (e.g., charge master, professional master, insurance master).
9. Monitors bankruptcy cases and notifies appropriate agencies accordingly.
10. Reviews microfiche for legibility and verifies that all reports are accounted for.
11. Promotes the values of the DMC by demonstrating behaviors supportive of a commitment to quality, community welfare, respect and involvement, teamwork, open and effective communication, innovation and education, and efficient and effective resource use.

Minimum Qualifications

1. High school graduate or equivalent.
2. One to three years of hospital billing or related experience.

Skills Required

1. Must possess firm understanding of accounts receivable, collection and third party payor processes.
2. Knowledge of basic accounting principles.
3. Operational computer skills.
4. Communication skills to interact with payors.
5. Analytical skills and high visual acuity to work on reports.

Facility Description

DMC Detroit Receiving Hospital, Michigan’s first Level I Trauma Center, helped pioneer the evolution of emergency medicine and currently has one of the busiest and most well-equipped emergency departments anywhere. The first and largest verified burn center in the state is at Receiving, and it is one of only 43 in the nation. Receiving also offers the state’s leading 24/7 hyperbaric oxygen program, Metro Detroit’s first certified primary stroke center, and the nationally recognized and accredited DMC Rosa Parks Geriatric Center of Excellence.

EEO Statement

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.
E-Verify:

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Tenet participates in the E-Verify program. Follow the link below for additional information.
E-Verify:
The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.