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

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

📋 Description

• Remote work opportunity (Salary Range: $19.2123-$28.8184)

• Conducts daily billing and follow-up tasks within the revenue operations for an assigned Patient Business Services (PBS) location.

• Acts as a member of the billing and follow-up team assigned to a PBS location, handling the billing and follow-up for both government and non-government accounts.

• Offers training and support to junior colleagues and addresses problem resolution as necessary.

• Records claims that are billed, paid, settled, and followed up in the appropriate systems.

• Recognizes and escalates issues that may impact precise billing and follow-up efforts.

• Follows proactive practices, which entail directly contacting payers for payments on accounts and ensuring timely and accurate responses to all mail correspondence.

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

• Executes all follow-up functions, including investigating overpayments, underpayments, credit balances, and payment delays.

• Ensures tasks are directed to the correct workflows to maximize reimbursements for rendered services and guarantees claims are processed or settled promptly and accurately.

• Investigates claim denials, makes necessary corrections, takes corrective actions, and/or refers claims to appropriate colleagues to ensure timely and accurate resolution.

• Actively follows up on delayed payments by reaching out to patients and third-party payers to identify the cause of the delay and provide additional information as needed.

• May generate special reports as requested by the Supervisor of Billing and Follow-Up to document follow-up services, such as the number of claims and dollars billed, claims edited, and unprocessed claims.

• Aids in the training and development of Billing and Follow-Up Representative I colleagues upon their hiring and continuously as new systems, processes, or payers emerge.

• Provides solutions to billing and follow-up challenges as required.

⛳️ Requirements

• High school diploma or Associate's degree in Accounting, Business Administration, or a related field.

• At least three (3) or more years of direct experience and relevant knowledge of revenue cycle functions and systems in a hospital or clinic environment, health insurance company, managed care organization, or another healthcare financial service setting, involving 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.

• Familiarity with hospital medical billing follow-up related to Medicaid/HM is highly desirable.

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

• Exceptional verbal and written communication and organizational skills.

• Strong interpersonal abilities are essential for interacting with internal and external customers.

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

• Capability to work independently.

🏝️ Benefits

• Competitive salary and flexible work arrangements.

• Opportunities for professional development and training.

• Supportive work environment with a focus on employee well-being.