Role Description
Performs day-to-day billing and follow-up activities within the revenue operations of an assigned Patient Business Services (PBS) location. Serves as a member of the billing and follow-up team at a PBS location responsible for billing and follow-up of government and non-government accounts. The position reports directly to the Supervisor Billing and Follow-up.
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Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
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Performs daily activities as part of the billing and follow-up team in support of the revenue cycle process for an assigned PBS location.
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Documents claims billed, paid, settled, and follow-up in appropriate system(s).
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Identifies and escalates issues affecting accurate billing and follow-up activities.
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Adheres to proactive practices which include contacting the payer directly for payment due on accounts and reviewing and responding to all mail correspondence in a timely and accurate manner.
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Communicates with appropriate hospital departments to clarify billing discrepancies and obtains demographic, clinical, financial, and insurance information.
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Performs all routine follow-up functions which includes the investigation of overpayments, underpayments, credit balances, and payment delays.
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Researches claim rejections, makes corrections, takes corrective actions, and/or refers claims to appropriate colleagues to ensure timely and accurate claim resolution.
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Proactively follows up on delayed payments by contacting patients and third-party payers determining the cause for delay and supplying additional data as required.
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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.
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Other duties as needed and assigned by the supervisor.
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Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Healthβs Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures.
Qualifications
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High School diploma and at least one (1) year of experience and relevant knowledge of revenue cycle functions and systems.
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Experience in a hospital or clinic environment, health insurance company, managed care organization, or other health care financial service setting.
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Basic understanding of Microsoft Office, including Outlook, Word, PowerPoint, and Excel.
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Completion of regulatory/mandatory certifications and skills validation competencies preferred.
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Excellent verbal and written communication and organizational abilities.
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Strong interpersonal skills are necessary in dealing with internal and external customers.
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Accuracy, attention to detail, and time management skills.
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Ability to work independently.
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Ability to perform billing and follow-up activities in a prompt and accurate manner.
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Must be comfortable operating in a collaborative, shared leadership environment.
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Must possess a personal presence characterized by honesty, integrity, and caring.
Requirements
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Must be able to set and organize own work priorities and adapt to them as they change frequently.
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Must be able to work concurrently on a variety of tasks/projects in a potentially stressful environment.
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Must possess the ability to comply with Trinity Health policies and procedures.
Company Description
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.