Position Summary:

Under general direction, the Billing/Follow-up Rep Facility (Remote) is responsible for completing tasks associated with specific assignments. Specific job responsibilities will be in customer service, collections, cash posting, billing, etc. as assigned by CBO Managemen t. Billing/ Follow-up Rep Facility   is expected to perform assignment tasks within the quality and productivity standards assigned to position responsibilities.

Essential Functions and Responsibilities:

• Responsible promptly, professionalyand courteously to all customers needs. 

• Cooperates and communicates effectively with all McLaren Health Care team members. 

• Contributes to continuous quality improvement efforts.

• Completes tasks accurately and timely.

• Organizes time and prioritizes effectively.

• Practices cost effective measures.

• Maintains confidentiality in all matters regarding patients, the hospital, the department and human resources.

BILLING: Responsible for billing hospital and physician claims, for inpatients and outpatients treated in the hospital and clinic, on behalf of the patient, within insurance time filing limits.

• Interprets third party requirements and appropriately bills for facility and physician services within time filing requirements.    
• Performs necessary maintenance to patient accounts in the billing and claims editing systems.
• Responds timely to all patient and commercial inquiries either by phone or by written correspondence regarding patient accounts.
• Contacts insurance companies regarding unreleased and unprocessed bills.
• As assigned, Insurance Specialist will be responsible for developing relationships and working with respective vendors in a timely and professional manner.
• Works with other departments and insurance companies to resolve bill/claim edits.
• Notify Analyst of edits that needs to be built and Denials Rep for denial trends.
• Coordinates and monitors billing activities relating to bone marrow transplant package pricing. 

FOLLOW UP:  Responsible for follow-up with third party payors for inpatients and outpatients treated in the hospital and clinic necessary to obtain payment and/or a resolution of patient accounts within insurance time filing limits.

• Performs necessary maintenance to patient accounts in the hospital and claims editing systems.
• Responds timely to all patient and commercial inquiries either by phone or by written correspondence regarding patient accounts.
• Contacts insurance companies regarding outstanding insurance bills.
• Follows-up on Age Trial Balance Report monthly.
• As assigned, Billing Specialist will be responsible for developing relationships and working with respective vendors in a timely and professional manner.
• Notify Analyst of edits that needs to be built and Denials Rep for denial trends.
• Resolves issues involving third party payor and self-pay claims. 

Qualifications: 

Minimum:

• High School Diploma or GED 

Preferred:

• Associate Degree in Health Care, Finance or related area. Equivalent combination of education and relevant experience.

• Working knowledge of CPT, HCPCS, and ICD-1

• One year experience in hospital financial or patient services 

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans