Third Party Billing And Follow Up Representative - Patient Financial Service

Job Overview

This Third-Party Billing and Follow-Up Representative facilitates billing and collection processes for outstanding accounts receivable. The role analyzes claims, confirms demographics and billing information, recommends improvements to billing and collection practices, processes legal requests for information, and ensures compliance with local and federal regulations.

• Facilitate billing and collection processes for outstanding accounts receivable.
• Communicate with internal and external contacts to resolve billing, collection, and claims, including Medicare and other government and non-government accounts.
• Monitor daily queue performance, maintain acceptable levels, and alert management of high call volume patterns.
• Handle incoming and outgoing billing correspondence and phone inquiries related to patients, third-party administrators, attorneys, vendors, and insurance payers.
• Document conversations and actions taken to support all claims inquiries, review and/or reconsiderations.
• Analyze claims for compliance and accurate coding and charging, and confirm demographic and billing information is updated.
• Resolve claim or billing concerns, escalating issues to management when appropriate.
• Develop relationships with patients, third-party administrators, attorneys, vendors, and other insurance payers.
• Perform follow-up processes on accounts to work toward a zero balance.
• Submit timely reconsideration or review of claim with supporting documentation such as corrected claim, medical records, and letter of explanation.
• Use software and hospital systems in accordance with policies and procedures.
• Perform account system updates such as changes to financial class, eligibility status, payor contact information, or rebills.
• Communicate with team members of any changes or updates that may impact workflow outcomes such as billing address or contact information.
• Perform balance transfers.
• Develop weekly productivity reports for management and recommend improvements to billing and collection practices.
• Process legal requests for information and ensure proper authorization is on file to support the request.
• Maintain compliance with all billing and collections practices and regulations set forth by local and federal government and governing agencies such as CMS, AHIMA, HIPAA, etc.
• Complete annual education requirements.
• Perform special projects and other duties as assigned.

• High School Diploma or GED (must provide proof at time of interview).
• One (1) year of experience in healthcare billing.

• One (1) year of experience in hospital third-party billing and account follow-up within a multi-hospital system.
• Bilingual English/Spanish or English/Polish.

• Knowledge of 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 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.
• Strong interpersonal and customer service skills.
• Good phone and email etiquette with strong response times.
• Good computer and typing skills.
• Analytical, problem-solving, critical thinking, and conflict resolution skills.
• Attention to detail, accuracy, and precision.
• Prioritization, planning, and organization of projects and tasks.
• Multi-tasking and meeting deadlines in a fast-paced stressful environment.
• Adherence to department policies and standards utilizing best practices.
• Professional demeanor and composure when challenged.
• Autonomous and team member in a multidisciplinary team.
• Accurate and reliable mathematical calculations.

This position functions within a healthcare environment. The incumbent is responsible for adherence to all safety requirements, including personal protective equipment, hand washing and sanitizing practices, and work area safety precautions specified by hospital policy and departmental procedures.

Preference is given to honorably discharged Veterans who have served in the United States Armed Forces for not less than 6 months of continuous service.

• Medical, Dental, and Vision Coverage
• Basic Term Life Insurance
• Pension Plan
• Deferred Compensation Program
• Paid Holidays, Vacation, and Sick Time