Billing and Follow up Representative II, Medical Billing Follow-up – HB & PB, All Payors, Ambulatory Surgery Center

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.

• Contribute to the revenue cycle process as a member of the billing and follow-up team.

• Record claims billed, paid, settled, and follow-up actions in the appropriate systems.

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

• Directly communicate with payers regarding outstanding payments on accounts.

• Review and respond to mail correspondence accurately and in a timely manner.

• Collaborate with hospital departments to address billing discrepancies and gather demographic, clinical, financial, and insurance details.

• Investigate instances of overpayments, underpayments, credit balances, and payment delays.

• Assign tasks to the correct workflows to optimize reimbursement and ensure claims are paid or settled correctly and promptly.

• Research claim denials, make adjustments, take corrective measures, or escalate claims for resolution.

• Follow up on delayed payments with patients and third-party payers, ascertain causes, and provide additional information as needed.

• Prepare special reports as requested by the Supervisor of Billing and Follow-Up.

• Assist in the training and education of Billing and Follow-up Representative I colleagues.

• Provide solutions for billing and follow-up challenges.

• Carry out other responsibilities assigned by the supervisor.

• Stay informed about relevant laws, regulations, Trinity Health compliance programs, the Code of Conduct, policies, and procedures.

⛳️ 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.

• Experience in a hospital or clinic setting, health insurance company, managed care organization, or another healthcare financial service environment.

• Background in medical claims processing, financial counseling, financial clearance, accounting, or customer service, or an equivalent combination of education and experience.

• Experience with critical access and/or rural health is highly desirable.

• Familiarity with denials billing, payment variances, and payor escalation is highly desirable.

• Experience with billing and follow-up in ambulatory surgery centers is highly desirable.

• Proficiency with Epic and HST medical billing software is desirable.

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

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

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

• Strong interpersonal skills to effectively engage with internal and external customers.

• Meticulous attention to detail, accuracy, and proficient time management skills.

• Ability to work independently.

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

• Must be comfortable functioning in a collaborative, shared leadership environment.

• Integrity, honesty, compassion, and the ability to inspire and motivate others are essential.

• Ability to establish and organize work priorities while adapting to frequent changes.

• Must be able to manage multiple tasks/projects concurrently in a potentially high-pressure environment.

• Must demonstrate compliance with Trinity Health's policies and procedures.

🏝️ Benefits

• Competitive salary and benefits package.

• Opportunities for professional development and career advancement.

• Supportive work environment focused on collaboration and teamwork.