Billing and Follow-up Representative-II (Hospital Medicaid Follow-up) – PFS (Remote)-Trinity Health

Job Description

Job Title: Billing and Follow-up Representative-II (Hospital Medicaid Follow-up) – PFS (Remote)

Company: Trinity Health

Location: Farmington Hills, MI

Pay:

AI Pay Analysis: To accurately analyze the hourly rate for the “Billing and Follow-up Representative-II (Hospital Medicaid Follow-up) – PFS (Remote)” in Farmington Hills, MI, it’s important to consider the typical pay range for similar roles within the healthcare billing and collections space. As of October 2023, hourly rates for such positions generally range from $15 to $25, depending on experience, specific responsibilities, and the employer’s size. In a remote setting and particularly in a healthcare context, competitive wages often align toward the upper end of that range, especially for roles requiring nuanced knowledge of Medicaid processes. If the offered rate falls within or above this range, it can be considered competitive and in line with industry standards, while rates below this may suggest a lack of competitiveness in the local job market.

Job description:

Employment Type: Full Time
Shift: Remote Position
Pay Range: $18.47 – $27.70

Position Purpose
The role involves performing essential billing and follow-up activities within the revenue operations for a designated Patient Business Services (PBS) location. As an integral member of the billing and follow-up team, you will be responsible for managing the billing and follow-up processes for both government and non-government accounts. You will provide training and guidance to junior colleagues and facilitate problem resolution as required. This position reports directly to the Supervisor of Billing & Follow-Up.

Essential Functions

• Embody and promote the Trinity Health Mission, Vision, and Values through your actions, practices, and decision-making processes.
• Engage in daily billing and follow-up activities that support the revenue cycle processes at your assigned PBS location.
• Document claims that are billed, paid, settled, and followed up on within the appropriate systems.
• Identify and escalate issues that may hinder accurate billing and follow-up efforts.
• Utilize proactive practices by directly contacting payers regarding payments due, and manage correspondence with accuracy and timeliness.
• Communicate effectively with relevant hospital departments to resolve billing discrepancies and gather necessary demographic, clinical, financial, and insurance information.
• Conduct follow-up functions that involve investigating overpayments, underpayments, credit balances, and payment delays, ensuring that tasks are routed to appropriate workflows to maximize reimbursement.
• Research claim rejections, implement necessary corrections, and refer claims to colleagues as needed to facilitate timely resolution.
• Proactively follow up on delayed payments by reaching out to patients and third-party payers to ascertain causes for delays and provide additional data as necessary.
• Prepare special reports as directed by the Supervisor of Billing and Follow-Up, documenting follow-up services, such as claim statistics and financial data.
• Assist in the ongoing training and education of Billing and Follow-Up Representative I colleagues, particularly during onboarding and the introduction of new systems or processes.
• Provide resolution for billing and follow-up issues as they arise.
• Undertake additional duties as assigned by the supervisor.
• Maintain a thorough understanding of applicable Federal, State, and local laws and regulations, as well as Trinity Health’s Integrity and Compliance Program and Code of Conduct, to ensure adherence to ethical and professional standards.

Minimum Qualifications

• A high school diploma or an Associate’s degree in Accounting, Business Administration, or a related field is required, along with a minimum of three (3) years of relevant experience in revenue cycle functions and systems within a healthcare setting, such as a hospital, clinic, health insurance company, or managed care organization. Experience in a complex, multi-site environment is preferred.
• Proficiency in Microsoft Office Suite, including Outlook, Word, PowerPoint, and Excel.
• Completion of regulatory and mandatory certifications and skills validation competencies is preferable.
• Strong verbal and written communication skills coupled with exceptional organizational abilities.
• Demonstrated interpersonal skills are crucial when interacting with both internal and external stakeholders.
• Attention to detail, accuracy, and effective time management are essential.
• Ability to work independently while managing billing and follow-up activities promptly and accurately to minimize potential financial losses.
• Comfort operating in a collaborative and shared leadership environment is essential.
• Personal integrity characterized by honesty and a caring approach, with the ability to inspire and motivate others, in alignment with the philosophy, mission, vision, goals, and values of Trinity Health.

Physical and Mental Requirements and Working Conditions
This position is performed in a standard office environment that is well-lit, temperature-controlled, and free from hazards. Frequent communication occurring in-person and over the phone is expected, requiring good manual dexterity for keyboard operation. While the noise level is typically low to moderate, the role may involve prolonged hours of screen time, which can lead to eyestrain. The incumbent must be adept at setting and organizing work priorities while adapting to frequently changing demands and working concurrently on various tasks or projects in potentially stressful situations. Compliance with Trinity Health policies and procedures is mandatory.

Our Commitment to Diversity and Inclusion
Trinity Health is among the largest not-for-profit Catholic healthcare systems in the United States. Grounded in our Mission and Core Values, we embrace diversity, equity, and inclusion in all our endeavors. Our workforce consists of individuals with diverse experiences, backgrounds, and talents, allowing us to provide the best possible care to those we serve. Trinity Health is proud to be an Equal Opportunity Employer, and all qualified candidates will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

Job Posting Date: Wed, 30 Oct 2024 08:53:11 GMT

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