Billing Follow Up Representative II

Department:

10420 Home Office IL - Patient Accounts

Status:

Full time

Benefits Eligible:

Yes

Hou rs Per Week:

40

Schedule Details/Additional Information:

Day hours training hours is based on trainer hours usually with a start time between 730am-8am once training is completed discussion of schedule between leadership and teammate can take place.

Pay Range:

$21.85 - $32.80

Advocate Aurora Health candidates must live in these states: AL AK AR AZ DE FL GA IA ID IL* IN KS KY LA ME MI MO MS MT NC ND NE NH NM NV OH OK PA SC SD TN TX UT VA WI WV WY

MAJOR RESPONSIBILITIES

• Responsible for daily claims submissions (electronic transmittals personal computer applications and hard copy claims) to the appropriate responsible parties. Acts as a resource person assists teams with more complex issues works with team members to facilitate problem resolution and may provide training. May be involved in quality audit process productivity and special projects as assigned. Uses multiple systems to resolve outstanding claims according to compliance guidelines.
• Prebilling/billing and follow up activity on open insurance claims exercising revenue cycle knowledge (ie;CPTICD-10 and HCPCS NDC revenue codes and medical terminology).Will obtain necessary documentation from various resources.
• Ability to timely and accurately communicate with internal teams and external customers (ie;third party payors auditors other entity) via phone or mail and acts as a liaison with external third party payer (insurance) representatives to validate and correct information and ensure regulatory and contractual compliance. Comprehends incoming insurance correspondence and responds appropriately.
• Identifies and brings patterns/trends to leaderships attentionre:coding and compliance contracting claim form edits/errors and credentialing for any potential in delay/denial of reimbursement. Obtains and keeps abreast with insurance payer updates/changes single case agreements and assists management with recommendations for implementation of any edits/alerts.
• Accurately enters and/or updates patient/insurance information into patient accountingsystem. Appeals claims to assure contracted amount is received from third party payors.
• Complies and maintains KPI (Key Performance Indicators) for assigned payers within standards established by department and insurance guidelines. Compile information for referral of accounts to internal/external partners as needed. Compile and maintain clear accurate on-line documentation of all activity relating to billing and collection efforts for each account utilizing established guidelines.
• Responsible to read and understand all Advocate Aurora Health policies and departmental collections policies and procedures. Demonstrate proficiency in proper use of the software systems employed by AAH.
• This position refers to the supervisor for approval or final disposition such as: recommendations regarding handling of observed unusual/unreasonable/inaccurate accountinformation. Approval needed to write off balances according to corporate policy. Issues outside normal scope of activity and responsibility.

MINIMUM EDUCATION AND EXPERIENCE REQUIRED

• Level of Education: High School Diploma or General Education Degree (GED)
• Years of Experience: Typically requires 2 years of related experience in medical/billing reimbursement environment or equivalent combination of education and experience.

MINIMUM KNOWLEDGE SKILLS AND ABILITIES (KSA)

• Basic keyboarding proficiency.
• Must be able to operate computer and software systems in use at Advocate Aurora Health.
• Able to operate a copy machine facsimile machine telephone/voicemail.
• Ability to read write speak and understand English proficiently.
• Ability to read and interpret documents such as explanation of benefits (EOB) operating instructions and procedure manuals.
• Knowledge of medical terminology coding terminology (CPTICD-10HCPC) and insurance/reimbursement practices.
• Ability to problem solve complex billing coding and contract issues.
• Able to use Zoom Microsoft office or other communication software for meetings.
• Proficient knowledge base and understanding of department-specific policies and procedures.
• Strong analytic organization communication (written and verbal) and interpersonal skills.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs competitive compensation generous retirement offerings programs that invest in your career development and so much more so you can live fully at and away from work including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications skills relevant experience and/or training

• Premium pay such as shift on call and more based on a teammates job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical dental vision life andShort- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g. full-time part-time per diem temporary etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Required Experience:

Unclear Seniority