Billing and Follow Up Representative-II (Hospital Medical Claims Follow-up-Medicaid -Ohio) -PFS (Remote)-Trinity Health

Job Description

Job Title: Billing and Follow Up Representative-II (Hospital Medical Claims Follow-up-Medicaid -Ohio) -PFS (Remote)

Company: Trinity Health

Location: Farmington Hills, MI

Pay:

AI Pay Analysis: To accurately analyze the competitiveness of the hourly rate for the role of “Billing and Follow Up Representative-II (Hospital Medical Claims Follow-up-Medicaid -Ohio) -PFS (Remote)” in Farmington Hills, MI, specific figures would be necessary for comparison. However, generally, positions in medical billing and follow-up, particularly those focused on Medicaid claims, commonly range from $16 to $25 per hour, depending on factors like experience, certification, and the employer. In Michigan, particularly for remote positions during and post-COVID-19, rates may vary. If the offered rate falls within or exceeds this range, it can be considered competitive and aligned with industry standards. If it’s below this range, it may be less attractive compared to other similar roles in the region.

Job description:

Employment Type: Full-time
Shift: Day Shift

Description:
POSITION PURPOSE
This is a remote position with a pay rate of $18.8367 – $28.2551. The role involves performing daily billing and follow-up activities within the revenue operations for a designated Patient Business Services (PBS) location. As a member of the billing and follow-up team, you will be responsible for managing both government and non-government accounts. The position will also entail providing training and guidance to junior colleagues and resolving issues as they arise. Direct reporting will be to the Supervisor of Billing & Follow-Up.

ESSENTIAL FUNCTIONS

• Understand, embody, and demonstrate the Trinity Health Mission, Vision, and Values in all interactions and decisions.
• Engage in daily tasks as part of the billing and follow-up team, contributing to the revenue cycle for your assigned PBS location.
• Accurately document claims that have been billed, paid, settled, and require follow-up within appropriate systems.
• Identify and escalate issues that may affect accurate billing and thorough follow-up procedures.
• Employ proactive practices, including direct communication with payers regarding payment due on accounts and ensuring timely and accurate responses to all mail correspondence.
• Collaborate with relevant hospital departments to clarify billing discrepancies and gather necessary demographic, clinical, financial, and insurance information.
• Manage all follow-up functions, including investigating overpayments, underpayments, credit balances, and payment delays. Ensure that tasks are routed to the appropriate workflows with the aim of maximizing reimbursement and facilitating timely claims resolution.
• Research claim rejections and implement necessary corrections, referring claims to appropriate colleagues when timely resolution is not achievable.
• Take the initiative to follow up on delayed payments through direct communication with patients and third-party payers to identify causes for delays and provide additional information as needed.
• Prepare special reports as directed by the Supervisor of Billing and Follow-Up to track follow-up activities, including number of claims billed, claims edited, and claims unprocessed.
• Facilitate training and education for Billing and Follow-Up Representative I colleagues upon their hire and as necessary with the introduction of new systems, processes, or payers.
• Provide problem resolution for billing and follow-up issues as required.
• Perform additional duties as assigned by the supervisor.
• Maintain an 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 professional conduct.

MINIMUM QUALIFICATIONS

• High school diploma or an Associate’s degree in Accounting, Business Administration, or a related field, accompanied by a minimum of three (3) years of direct experience and knowledge of revenue cycle functions in a healthcare environment, health insurance company, or financial service setting. Alternative combinations of education and experience may be considered. Experience in a complex, multi-site environment is preferred.
• Proficient in Microsoft Office Suite (Outlook, Word, PowerPoint, Excel).
• Experience with hospital medical claims follow-up with Medicaid in Ohio is highly desirable.
• Familiarity with the Epic medical billing system is also highly desirable.
• Completion of regulatory/mandatory certifications and skills validation competencies is preferred.
• Exceptional verbal and written communication skills, along with strong organizational abilities.
• Excellent interpersonal skills to effectively engage with both internal and external clients.
• High degree of accuracy, attention to detail, and effective time management skills.
• Ability to work independently while managing multiple priorities.
• Competence in executing billing and follow-up tasks with precision to minimize potential financial loss to patients and the organization.
• Must thrive in a collaborative, shared leadership environment, demonstrating integrity and compassion that inspires and motivates peers to uphold the mission and values of Trinity Health.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
This position operates within a typical office environment, which is well-lit, temperature-controlled, and free from hazards. The incumbent will frequently communicate both in person and over the phone regarding product support issues. Manual dexterity is required to operate a keyboard, and keen hearing is necessary for effective communication. Due to extended hours spent viewing a CRT screen, the role is subject to eyestrain. The work environment may involve managing multiple tasks and priorities, requiring adaptability and resilience in a dynamic atmosphere alongside individuals with varied work styles. Compliance with Trinity Health policies and procedures is essential.

The responsibilities outlined above describe the general nature and level of work expected from individuals in this role. They are not meant to be an exhaustive list of duties.

Our Commitment to Diversity and Inclusion
Trinity Health is among the largest non-profit, Catholic healthcare systems in the United States. Rooted in our Mission and Core Values, we prioritize diversity, equity, and inclusion in all our endeavors. Our workforce is enriched by diverse perspectives, experiences, and capabilities. Together, we strive for excellence and inclusivity in care. Trinity Health is an Equal Opportunity Employer; all qualified applicants will be considered for employment without regard to 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: Thu, 31 Oct 2024 08:46:14 GMT

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