Billing and Follow-Up Representative II – Hospital Follow-Up, Medicaid/HMO Payor

This is a fully remote position, open to applicants in Michigan.

📋 Description

• Execute daily billing and follow-up tasks within revenue operations for a designated Patient Business Services location.

• Assist in the revenue cycle process for the assigned PBS location.

• Document claims that have been billed, paid, settled, and followed up in the appropriate systems.

• Identify and escalate issues that impact accurate billing and follow-up.

• Directly contact payers to secure payments due on accounts and review/respond to mail correspondence.

• Communicate with hospital departments to resolve billing discrepancies and gather demographic, clinical, financial, and insurance information.

• Investigate overpayments, underpayments, credit balances, and delays in payments.

• Route tasks to the correct workflows to optimize reimbursement and ensure timely claim payment or settlement.

• Research claim rejections, implement corrections, take corrective actions, or refer claims for further resolution.

• Follow up on delayed payments with patients and third-party payers.

• Prepare special reports as requested by the supervisor.

• Assist in training and educating Billing and Follow-up Representative I colleagues.

• Provide resolutions for billing and follow-up challenges.

• Carry out other duties as assigned by the supervisor.

• Stay informed about applicable laws, regulations, Trinity Health policies, Integrity and Compliance Program, and Code of Conduct.

⛳️ Requirements

• High school diploma or Associate's degree in Accounting, Business Administration, or a related field, along with a minimum of three (3) years of direct experience and relevant knowledge of revenue cycle functions and systems within a hospital, clinic, health insurance company, managed care organization, or other healthcare financial service environments, performing medical claims processing, financial counseling, financial clearance, accounting, or customer service activities, or an equivalent combination of education and experience.

• Experience in a complex, multi-site environment is preferred.

• Proficiency in Microsoft Office Suite, including Outlook, Word, PowerPoint, and Excel.

• Completion of regulatory/mandatory certifications and skills validation competencies is preferred.

• Excellent verbal and written communication skills, along with strong organizational abilities.

• Strong interpersonal skills for effective interaction with both internal and external customers.

• High level of accuracy, attention to detail, and effective time management skills.

• Ability to work independently.

• Capability to perform billing and follow-up activities promptly and accurately.

• Comfortable in a collaborative, shared leadership environment.

• Ability to adhere to Trinity Health policies and procedures.

🏝️ Benefits

• Remote work opportunity.

• Day shift schedule.

• Equal Opportunity Employer.