Billing and Follow-Up Representative II

Role Description

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 provides problem resolution as needed. This position reports directly to a Supervisor Billing & Follow-Up.

• 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.
• Researches claim rejections, makes corrections, takes corrective actions, and/or refers claims to appropriate colleagues to ensure timely and accurate claim resolution.
• Proactively follows 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.
• Assists in the training and education of Billing and Follow-up Representative I colleagues upon hire and ongoing.
• Provides problem resolution to billing and follow-up issues as needed.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Integrity and Compliance Program and Code of Conduct.

Qualifications

• High school diploma or Associate's degree in Accounting or Business Administration or related field.
• Minimum of three (3) or more years of direct experience and relevant knowledge of revenue cycle functions and systems.
• Experience in a complex, multi-site environment preferred.
• Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel.
• Experience and knowledge of hospital medical billing follow-up with Medicaid/HM highly desirable.
• Completion of regulatory/mandatory certifications and skills validation competencies preferred.
• Excellent verbal and written communication and organizational abilities.
• Strong interpersonal skills are necessary in dealing with internal and external customers.
• Accuracy, attention to detail and time management skills.
• Ability to work independently.
• Must be comfortable operating in a collaborative, shared leadership environment.
• Must possess a personal presence characterized by honesty, integrity, and caring.

Requirements

• Ability to perform billing and follow-up activities in a prompt and accurate manner.
• 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 a potentially stressful environment.
• Must possess the ability to comply with Trinity Health policies and procedures.

Benefits

• Rooted in our Mission and Core Values, we honor the dignity of every person.
• Recognize the unique perspectives, experiences, and talents each colleague brings.
• Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to protected statuses.