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Advocate Aurora Health · 2 days ago

Billing Follow Up Rep II

United States

Full-time

Remote

Entry, Mid Level

$21.45/hr - $32.20/hr

2+ years exp

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. They are seeking a Billing Follow Up Representative to manage daily claims submissions, communicate with internal teams and external customers, and ensure compliance with billing regulations.

Health Care

Responsibilities

Responsible for daily claims submissions (electronic transmittals, personal computer applications and hard copy claims) to the appropriate responsible parties. Acts as a resource person, assists teams with more complex issues, works with team members to facilitate problem resolution and may provide training. May be involved in quality audit process, productivity, and special projects as assigned. Uses multiple systems to resolve outstanding claims according to compliance guidelines

Prebilling/billing and follow up activity on open insurance claims exercising revenue cycle knowledge (ie;CPT,ICD-10 and HCPCS, NDC, revenue codes and medical terminology).Will obtain necessary documentation from various resources

Ability to timely and accurately communicate with internal teams and external customers (ie;third party payors, auditors, other entity) via phone or mail and acts as a liaison with external third party payer (insurance) representatives to validate and correct information and ensure regulatory and contractual compliance. Comprehends incoming insurance correspondence and responds appropriately

Identifies and brings patterns/trends to leaderships attention re:coding and compliance, contracting, claim form edits/errors and credentialing for any potential in delay/denial of reimbursement. Obtains and keeps abreast with insurance payer updates/changes, single case agreements and assists management with recommendations for implementation of any edits/alerts

Accurately enters and/or updates patient/insurance information into patient accounting system. Appeals claims to assure contracted amount is received from third party payors

Complies and maintains KPI (Key Performance Indicators) for assigned payers within standards established by department and insurance guidelines. Compile information for referral of accounts to internal/external partners as needed. Compile and maintain clear, accurate, on-line documentation of all activity relating to billing and collection efforts for each account, utilizing established guidelines

Responsible to read and understand all Advocate Aurora Health policies and departmental collections policies and procedures. Demonstrate proficiency in proper use of the software systems employed by AAH

This position refers to the supervisor for approval or final disposition such as: recommendations regarding handling of observed unusual/unreasonable/inaccurate account information. Approval needed to write off balance’s according to corporate policy. Issues outside normal scope of activity and responsibility

Qualification

Medical terminologyCPT codingICD-10 codingBilling/reimbursement experienceAnalytical skillsPatient accounting systemsKeyboarding proficiencyMicrosoft OfficeCommunication skillsProblem-solving skills