Advocate Health
Healthcare
BillingFollowUp-Representative
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optimal for Entry candidates.
“Billing Follow Up- Representative at Advocate Health. Skills: Billing follow up, Revenue cycle, Insurance claims. Review accounts and apply billing follow up. Resolve outstanding claims”
What You'll Achieve.
Insure proper and maximum reimbursement; Assure contracted amount is received; Complies and maintains KPI for assigned payers within standards
Industry & Context.
Resolve outstanding claims; Identifies and brings patterns/trends to leaderships attention
Some travel required
What They're Looking For.
Must Have
1 year of related experience in medical billing reimbursement environment, High School Diploma or General Education Degree (GED)
Nice to Have
Knowledge of medical terminology, Knowledge of coding, Knowledge of terminology (CPT, ICD-10, HCPC), Knowledge of insurance/reimbursement practices
What You'll Do.
Review accounts and apply billing follow up
Resolve outstanding claims
Perform prebilling and follow up activity
Communicate with internal teams and external customers
Respond to insurance correspondence
Identify patterns/trends
Update patient/insurance information
Compile information for referral
Maintain documentation
Read and understand policies
How You'll Work.
Team & Collaboration
Communicate with internal teams; Acts as a liaison with external third party representatives; Compile information for referral of accounts to internal/external partners
Communication Scope
Ability to timely and accurately communicate; Ability to communicate well with people
Full Job Description
**Department:** 13529 Enterprise Revenue Cycle - Special Program Billing Ops: MW 1 **Status:** Full time **Benefits Eligible:** Yes **Hou****rs Per Week:** 40 **Schedule Details/Additional Information:** Located in IL hybrid some travel required. Core hours flexible M-F 6a-530p **Pay Range** $20.80 - $31.20 **MAJOR RESPONSIBILITIES** * Independently review accounts and apply billing follow up knowledge required for all insurance payors to insure proper and maximum reimbursement. 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) and acts as a liaison with external third party representatives to validate and correct information. * 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
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