Billing Follow Up Rep II

aah; Oak Brook (IL); On-site; USD 30,000 - 45,000; Full time

Job summary

Advocate Aurora Health in Oak Brook, IL seeks a Patient Accounts Specialist to handle daily claims submissions and follow-up in a busy revenue cycle environment.

You will liaise with payers, ensure CPT/ICD-10 coding accuracy, and support audits and process improvements. Two years in medical billing is preferred, with strong English, Excel/Office, and communication skills. 40-hour weeks, M-F.

Qualifications

• High school diploma or GED required.
• At least 2 years of related medical/billing experience.
• Knowledge of CPT, ICD-10, HCPCS and insurance reimbursement.

Responsibilities

• Submit daily claims electronically and on paper to the appropriate payers.
• Assist teams with more complex issues and provide training as needed.
• Perform prebilling, billing, and follow-up on open claims per compliance guidelines.
• Enter/update patient/insurance information in the billing system.
• Communicate with internal teams and external payers to resolve issues.
• Maintain KPI and document activity for billing and collection.

Skills

Keyboarding

English proficiency

Billing knowledge

Analytical skills

Communication skills

Education

High School Diploma or GED

Tools

Zoom

Microsoft Office

Job description

Department

10420 Home Office IL - Patient Accounts

Status

Full time

Benefits Eligible

Yes

Hours Per Week

40

Schedule Details/Additional Information

M-F days

Pay Range

$21.85 - $32.80

Eligible States

Advocate Aurora Health candidates must live in these states: AK, AL, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY

MAJOR RESPONSIBILITIES

Responsible for daily claims submissions (electronic transmittals, personal computer applications and hard copy claims) to the appropriate responsible parties. Acts as a resource person, assists teams with more complex issues, works with team members to facilitate problem resolution and may provide training. May be involved in quality audit process, productivity, and special projects as assigned. Uses multiple systems to resolve outstanding claims according to compliance guidelines.Prebilling/billing and follow up activity on open insurance claims exercising revenue cycle knowledge (ie;CPT,ICD-10 and HCPCS, NDC, revenue codes and medical terminology).Will obtain necessary documentation from various resources.Ability to timely and accurately communicate with internal teams and external customers (ie;third party payors, auditors, other entity) via phone or mail and acts as a liaison with external third party payer (insurance) representatives to validate and correct information and ensure regulatory and contractual compliance. Comprehends incoming insurance correspondence and responds appropriately.Identifies and brings patterns/trends to leaderships attention re:coding and compliance, contracting, claim form edits/errors and credentialing for any potential in delay/denial of reimbursement. Obtains and keeps abreast with insurance payer updates/changes, single case agreements and assists management with recommendations for implementation of any edits/alerts.Accurately enters and/or updates patient/insurance information into patient accounting system. Appeals claims to assure contracted amount is received from third party payors.Complies and maintains KPI (Key Performance Indicators) for assigned payers within standards established by department and insurance guidelines. Compile information for referral of accounts to internal/external partners as needed. Compile and maintain clear, accurate, on-line documentation of all activity relating to billing and collection efforts for each account, utilizing established guidelines.Responsible to read and understand all Advocate Aurora Health policies and departmental collections policies and procedures. Demonstrate proficiency in proper use of the software systems employed by AAH.This position refers to the supervisor for approval or final disposition such as: recommendations regarding handling of observed unusual/unreasonable/inaccurate account information. Approval needed to write off balance's according to corporate policy. Issues outside normal scope of activity and responsibility.

MINIMUM EDUCATION AND EXPERIENCE REQUIRED

Level of Education: High School Diploma or General Education Degree (GED)

Years of Experience: Typically requires 2 years of related experience in medical/billing reimbursement environment, or equivalent combination of education and experience.

MINIMUM KNOWLEDGE, SKILLS AND ABILITIES (KSA )

• Basic keyboarding proficiency.
• Must be able to operate 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.
• Knowledge of medical terminology, coding, terminology (CPT,ICD-10,HCPC) and insurance/reimbursement practices.
• Ability to problem solve complex billing, coding and contract issues.
• Able to use Zoom, Microsoft office, or other communication software for meetings.
• Proficient knowledge base and understanding of department-specific policies and procedures.
• Strong analytic, organization, communication (written and verbal), and interpersonal skills.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

• CompensationBase compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incent