Billing Follow-up Representative

16 hours ago

Oak Brook, Illinois, United States Advocate Health Full time
Job Summary

We are seeking a highly skilled Billing Follow-up Representative to join our team at Advocate Aurora Health. In this role, you will be responsible for reviewing accounts and applying billing follow-up knowledge to ensure proper and maximum reimbursement from insurance payors.

Key Responsibilities
  • Independently review accounts and apply billing follow-up knowledge to ensure proper and maximum reimbursement from insurance payors.
  • Use multiple systems to resolve outstanding claims according to compliance guidelines.
  • Prebilling/billing and follow-up activity on open insurance claims, exercising revenue cycle knowledge (e.g., CPT, ICD-10, HCPCS, NDC, revenue codes, and medical terminology).
  • Obtain necessary documentation from various resources.
  • Timely and accurately communicate with internal teams and external customers (e.g., third-party payors, auditors, and other entities).
  • Act as a liaison with external third-party representatives to validate and correct information.
  • Comprehend incoming insurance correspondence and respond appropriately.
  • Identify and bring patterns/trends to leadership's attention regarding coding and compliance, contracting, claim form edits/errors, and credentialing for potential delays or denials of reimbursement.
  • Obtain and keep abreast with insurance payer updates/changes, single-case agreements, and assist management with recommendations for implementation of any edits/alerts.
  • Accurately enter and/or update patient/insurance information into the patient accounting system.
  • Appeal claims to ensure contracted amounts are received from third-party payors.
  • Comply with and maintain KPIs for assigned payers within standards established by the department and insurance guidelines.
  • Compile information for referral of accounts to internal/external partners as needed.
  • Compile and maintain clear, accurate, online documentation of all activity relating to billing and follow-up efforts for each account, utilizing established guidelines.
Requirements
  • High School Diploma or General Education Degree (GED)
  • Typically requires 1 year of related experience in a medical/billing reimbursement environment, or equivalent combination of education and experience.
  • Must perform within the scope of departmental guidelines for productivity and quality standards.
  • Works independently with limited supervision.
  • Accountable and evaluated to organization behaviors of excellence.
  • Basic keyboarding proficiency.
  • Ability to operate a computer and software systems in use at Advocate Aurora Health.
  • Able to operate a copy machine, facsimile machine, telephone/voicemail.
  • Ability to read, write, speak, and understand English proficiently.
  • Ability to read and interpret documents such as explanation of benefits (EOB), operating instructions, and procedure manuals.
  • Preferred but not required knowledge of medical terminology, coding, terminology (CPT, ICD-10, HCPCS), and insurance/reimbursement practices.
  • Ability to communicate well with people to obtain basic information (via telephone or in person).

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