THIRD PARTY BILLING AND FOLLOW UP REPRESENTATIVE - PATIENT FINANCIAL SERVICE

Job Summary The Third-Party Billing and Follow up Representative facilitates the billing and collection processes of outstanding accounts receivable. The role analyzes claims to determine compliant and accurate coding, reviews files to confirm demographic and billing information is updated, and makes recommendations to improve billing and collection practices. The representative also processes legal requests for information, ensuring proper authorization is on file to support the request. Typical Duties Facilitate the billing and collection processes of outstanding accounts receivable. Communicate with internal and external contacts to explain primary, secondary, and tertiary billing, collection, and resolution of claims including Medicare and other government and non‑government accounts. Monitor daily queues for customer service quality and productivity to maintain acceptable levels, alerting management of high call volume patterns. Handle incoming and outgoing billing correspondence and phone inquiries relating to patients, third‑party administrators, attorneys, vendors, and other insurance payers. Document conversations and actions taken to support all claim inquiries, reviews, and reconsiderations; streamline the follow‑up process for team members. Analyze claims to determine compliant and accurate coding and charging; review files to confirm demographic and billing information is updated. Resolve claim or billing concerns and take appropriate action to escrow issues to management when necessary. Develop relationships with patients, third‑party administrators, attorneys, vendors, and other insurance payers. Perform follow‑up processes on accounts to work toward a zero balance. File timely reconsiderations or reviews of claims with supporting documentation such as corrected claims, medical records, and letters of explanation as necessary; communicate with departments to gather information needed to resolve the claim. Use the software and hospital systems in accordance with hospital policies and procedures. Perform account system updates such as changes to financial class, eligibility status, payor contact information, or rebills. Communicate with team members regarding changes or updates that may impact workflow outcomes such as billing address or contact information. Perform balance transfers. Develop weekly productivity reports for management; make recommendations to improve billing and collection practices to decrease reimbursement timeframe and increase payment accuracy. Process legal requests for information; ensure proper authorization is on file to support the request. Maintain compliance with all billing and collections practices and regulations set forth by local and federal government and other governing agencies, including CMS, AHIMMA, and HIPAA. Complete annual education requirements. Perform special projects and other duties as assigned. Reporting Relationships Reports to the System Supervisor of Third‑Party Billing and Collections. Minimum Qualifications High School Diploma or GED (must provide proof at time of interview). A minimum of one (1) year of experience in healthcare billing is required. Preferred Qualifications A minimum of one (1) year of experience in hospital third‑party billing and account follow‑up within a multi‑hospital system is preferred. Bilingual English/Spanish or English/Polish is preferred. Knowledge, Skills, Abilities and Other Characteristics Knowledge and familiarity with billing hierarchy levels and order of facilitation. Knowledge of compliance and regulations for billing and collection practices set forth by local and federal government and other governing agencies. Knowledge of billing and collection processes in a hospital environment. Knowledge of Microsoft Office Suite. Knowledge of a hospital revenue cycle system. Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups. Strong interpersonal and customer service skills. Demonstrate good phone and email etiquette skills with strong response times both on the phone and electronically. Demonstrate good computer and typing skills to support thorough documentation of phone call. Demonstrate analytical, problem‑solving, critical thinking, and conflict resolution skills. Demonstrate attention to detail, accuracy and precision. Ability to prioritize, plan, and organize projects and tasks. Ability to multi‑task and meet deadlines in a fast‑paced and stressful environment. Ability to adhere to department policies and standards utilizing best practices. Ability to maintain a professional demeanor and composure when challenged. Ability to function autonomously and as a team member in a multidisciplinary team. Ability to perform accurate and reliable mathematical calculations. Ability to see and hear clearly (including with correction). Physical and Environmental Demands This position is within a healthcare environment. The incumbent is responsible for adherence to all hospital and department specific safety requirements, including compliance with personal protective equipment, hand washing and sanitizing practices, engineering and work‑practice controls, and other safety precautions specified by hospital policy. Veteran Preference Preference is given to honorably discharged Veterans who have served in the U.S. Armed Forces for not less than 6 months of continuous service. To take advantage of the preference, a Veteran must meet minimum qualifications, identify self as a Veteran on the employment application, and attach a copy of a DD 214, DD 215, or NGB 22 (notice of separation) at time of application filing. If multiple copies are submitted, the one with the latest date will be used. Coast Guard Veterans must submit a certified copy of the military separation from the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11). Discharge papers listing an honorable discharge status are required; others are not acceptable. Alternatively, a valid State ID Card or Driver's License that identifies the holder as a Veteran may be attached to the application at time of filing. Veterans must provide original applicable discharge papers or state ID/driver's license at time of interview. All applicants must meet all required qualifications at time of application filing. Benefits Package Medical, Dental, and Vision Coverage Basic Term Life Insurance Pension Plan Deferred Compensation Program Paid Holidays, Vacation, and Sick Time Qualification for the Public Service Loan Forgiveness Program (PSLF) Additional Application Information All degrees awarded outside of the United States, except those awarded in U.S. territories and Canada, must be credentialed by an approved U.S. credential evaluation service belonging to NACES or AICE. Original credentialing documents must be presented at time of interview. All offers of employment are contingent upon satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications, and successful completion of a physical and pre‑employment drug screen. COOK COUNTY HEALTH AND HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER #J-18808-Ljbffr Direct Jobs