[Hiring] Billing and Follow-Up Representative-I Hospital BC/BS Payer @Trinity Health

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.

• 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 include 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 obtains demographic, clinical, financial, and insurance information.
• Performs all routine 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 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, e.g., number of claims and dollars billed, claims edited, claims unprocessed, etc.
• Other duties as needed and assigned by the supervisor.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures.

Qualifications

• High School diploma and successful completion of Trinity Health Trainee program or at least one (1) year of experience in revenue cycle functions and systems.
• Basic understanding of Microsoft Office, including Outlook, Word, PowerPoint, and Excel.
• Completion of regulatory/mandatory certifications and skills validation competencies preferred.
• Excellent verbal and written communication and organizational abilities.
• Strong interpersonal skills 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 to reduce potential financial loss to the patient and the Ministry Organization.

Physical and Mental Requirements and Working Conditions

• This position operates in a typical office environment, well lit, temperature controlled, and free from hazards.
• Incumbent communicates frequently, in person and over the phone, with people in all locations on product support issues.
• Manual dexterity is needed to operate a keyboard; hearing is needed for extensive telephone and in-person communication.
• The incumbent is subject to eyestrain due to many hours spent looking at a CRT screen.
• 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.

Our Commitment

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. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.