Third Party Billing and Follow Up Representative - Chicago, United States - Cook County Health & Hospitals System

Mark Lane

Posted by:

Mark Lane

beBee recruiter


Description

THIRD PARTY BILLING AND FOLLOW UP REPRESENTATIVE - PATIENT FINANCIAL SERVICES

Job Number:
**
Job Posting: May 9, 2024, 12:58:22 PM
Closing Date: May 23, 2024, 11:59:00 PM

Full-time
Shift Start Time: 8:00 A

M
Shift End Time:

4:00 P.M.


Collective Bargaining Unit:
AFSCME 1178


Posting Salary:
$23.351 HOURLY


Organization:
Health and Hospital Systems


JOB TITLE:
Third Party and Follow Up Representative


DEPARTMENT:
Patient Financial Services


LOCATION: 600 Holiday Plaza Dr, Matteson, IL 60443


SHIFT:8:00 AM - 4:00 PM


Job Summary
AFSCME 1178
The Third-Party Billing & Follow Up Representative facilitates the billing and collection processes of outstanding accounts receivable. Analyzes claims to determine compliant and accurate coding, charging; reviews file to confirm demographic and billing information is updated.

Makes recommendations to improve billing and collection practices in an effort to decrease the reimbursement timeframe and accuracy of payment.

Processes legal requests for information; ensures proper authorization is on file to support the request.


Typical Duties

  • Facilitates the billing and collection processes of outstanding accounts receivable.
  • Communicates with internal and external contacts to explain primary, secondary and tertiary billing, collection and resolution of claims including Medicare and other government and nongovernment accounts.
  • Monitors daily queues for customer services/quality and productivity to maintain acceptable level as established by the departments, alerts management of high call volume patterns.
  • Handles incoming and outgoing billing correspondence and phone inquiries relating to patient, third party administrators, attorneys, vendors and other insurance payers.
  • Documents conversations and/or actions taken to support all claims inquiries, review and/or reconsiderations; streamlines the followup process of team members assisting on the file.
  • Analyzes claims to determine compliant and accurate coding, charging; reviews file to confirm demographic and billing information is updated.
  • Works to resolve any claim or billing concerns and takes appropriate action to escalate issues to management when appropriate.
  • Develops relationships with patients, third party administrators, attorneys, vendors and other insurance payers.
  • Performs followup processes on accounts to work towards a zero balance.
  • Files a timely reconsideration or review of claim with supporting documentation such as a corrected claim, medical records and letter of explanation as necessary; communicates with departments to gather information needed to resolve the claim.
  • Makes use of the software and hospital systems in accordance with hospital policies and procedures.
  • Performs account system updates such as changes to financial class, eligibility status, payor contact information or rebills.
  • Communicates with team members of any changes or updates that may impact workflow outcomes such as billing address or contact information.
  • Performs balance transfers.
  • Develops weekly productivity reports for management; makes recommendations to improve billing and collection practices in an effort to decrease the reimbursement timeframe and accuracy of payment.
  • Processes legal requests for information; ensures proper authorization is on file to support the request.
  • Maintains compliance with all billing and collections practices and regulations set forth by local and federal government and any other governing agencies to include but not limited to Center for Medicaid & Medicare Services (CMS), American Health Information Management Association (AHIMMA), Health Insurance Portability and Accountability Act (HIPAA), etc.
  • Completes annual education requirements.
  • Performs special projects and other duties as assigned.

Minimum Qualifications

  • High School Diploma or GED
  • One
    (1)
    year of experience in hospital third party billing and account followup.
  • Current experience with a hospital revenue cycle system.

Preferred Qualifications

  • One (1) year of experience in hospital third party billing and account followup within a multihospital system.
  • Bilingual

Knowledge, Skills, Abilities and Other Characteristics

  • Knowledge and familiarity with billing hierarchy levels and order of facilitation.
  • Knowledge of compliance and regulations for billing and collection practices set forth by local and federal government and any other governing agencies.
  • Knowledge of billing and collection processes in a hospital environment.
  • Knowledge of Microsoft Office Suite.
  • Knowledge of a hospital revenue cycle system.
  • Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups.
  • Strong interpersonal and customer service skills.
  • Demonstrate good computer and typing skills to support thorough docum

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