Job Closed
This listing is no longer active.
We are one of the largest not-for-profit, faith-based health care systems in the nation.
Billing and Follow-up Representative, Hospital Medical Billing Follow-up
Location
Michigan
Posted
56 days ago
Salary
$17 - $25 / hour
Seniority
Junior
Job Description
Billing and Follow-up Representative, Hospital Medical Billing Follow-up
Trinity Health
• Perform day-to-day billing and follow-up activities in revenue operations • Document claims billed, paid, settled, and follow-up in appropriate systems • Identify and escalate issues affecting accurate billing and follow-up • Contact payers directly for payment due on accounts • Review and respond to mail correspondence in a timely manner • Communicate with hospital departments to clarify billing discrepancies • Investigate overpayments, underpayments, credit balances, and payment delays • Research claim rejections and make necessary corrections • Conduct follow-ups on delayed payments • Prepare special reports as directed by the Supervisor.
Job Requirements
- High School diploma
- Successful completion of Trinity Health Trainee program or at least one (1) year of experience in revenue cycle functions
- Relevant knowledge of hospital or clinic environments, health insurance companies, managed care organizations, or health care financial services
- Basic understanding of Microsoft Office (Outlook, Word, PowerPoint, Excel)
- Excellent verbal and written communication abilities
- Strong organizational skills
- Strong interpersonal skills in dealing with internal and external customers
- Accuracy, attention to detail, and time management skills
- Ability to work independently
- Ability to perform billing and follow-up activities efficiently
- Comfort in operating in a collaborative, shared leadership environment
- Personal presence characterized by honesty, integrity, and caring.
Related Guides
Related Categories
Related Job Pages
More Medical Billing and Coding Jobs
Role Description As a Certified Coding Lead in healthcare, you will play a crucial role in ensuring accurate and timely coding of medical records. You will be responsible for leading a team of coders and ensuring compliance with industry standards and regulations. Your work will directly impact the quality of patient care and the financial health of the organization. You will have the opportunity to work with cutting-edge technology and collaborate with healthcare professionals to improve patient outcomes. - Lead a team of coders to ensure accurate and timely coding of medical records - Perform high-level audits to ensure compliance with industry standards and regulations - Collaborate with healthcare professionals to improve patient outcomes - Provide training and support to team members - Stay up-to-date with industry developments and best practices - Use independent judgment in coding guidelines to ensure compliance with CMS, Medicare, Medicaid and payer policies Qualifications - Certification in medical coding (e.g. CPC, CCS) - Minimum of 5 years of experience in Cardiology/ Vascular medical coding - Strong knowledge of ICD-10-CM and CPT coding systems - Excellent attention to detail and accuracy - Strong leadership and communication skills Requirements - Bachelor's degree in Health Information Management or equivalent coding management experience (preferred) - Experience with electronic health record (EHR) systems (preferred) - Experience with coding audits and quality assurance (preferred) - Experience with team management and performance evaluation (preferred) Remote Work Requirements - Must be available to work during scheduled work hours, except for lunch and breaks - A Quiet, distraction-free environment - High-speed private internet connection - Respond to all non-urgent calls and emails within 1 business day - Notify your manager immediately for any technical and/or access issues that prevent you from completing your work - Notify your manager at least 30 minutes prior to your scheduled start time for any unplanned days off Work Environment This position is a Remote position Monday- Friday from 8:00 am – 5:00 PM. Physical Requirements This position requires full range of body motion. While performing the duties of this job, the employee is regularly required to sit, walk, and stand; talk or hear, both in person and by telephone; use hands repetitively to handle or operate standard office equipment; reach with hands and arms; and lift up to 25 pounds. Equal Employment Opportunity Statement We provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Salary and Benefits Full-time, Exempt position. Competitive compensation and benefits package to include 401K; a full suite of medical, dental, and ancillary benefits; paid time off, and much more.
Role Description A coder for Nexus Health Systems has the primary role of accurate coding and DRG assignment for all Nexus facilities. Under the System Director Health Information Management supervision, the coder will maintain professional certification while demonstrating a working knowledge of LTC MS-DRGs, APR-DRGs, ICD-9-CM, ICD-10-CM, and CPT coding requirements. The coder will be directly responsible for admission, concurrent and discharge coding, meeting the facility coding turnaround times, abstracting, coding query compliance, working with CDI to improve physician documentation and metrics utilization. This 100% remote corporate position is based out of Nexus Specialty Hospital. The position requires travel to the facility only for scheduled meetings and mandatory in-services. Qualifications - Completion of a 2 or 4 year accredited Health Information Management degree program preferred. - Minimum of 4 years experience with inpatient ICD-9-CM and PCS coding and CPT coding. Long Term Acute Care coding experience preferred. - Working knowledge of LTC-MS-DRGs, APR-DRG’s, coding query utilization, and documentation improvement practices. - ICD-10 Training completed. Dual coding experience preferred. - RHIA, RHIT, or CCS with certification maintenance. - Maintain current certification in good standing during employment with this facility, or obtain within thirty (30) days of hire. Requirements - Adheres to the turnaround times designated by Nexus for timely and accurately coding, timely communication of DRG assignment and updates, and claim creation for timely billing. - Responsible for assigning principal diagnosis within 24 hours of H&P completion, daily concurrent abstracting and review, and final DRG and code assignment within 72 hours of discharge. - Accurately abstracts and audits medical records for documentation compliance and accuracy to reflect accurate code assignment to support illness severity and service intensity. - Recognizes the role of a coder and how it relates to the overall clinical function of the hospital regarding correct documentation of patient care and fiscal reimbursement. - Identifies documentation improvement areas through admission, concurrent, and discharge abstracting and utilizes coding queries to meet specific coding guidelines. - Creation, implementation, and tracking of coding query compliance for physicians. - Plays an active role in the weekly DRG multi-disciplinary meetings to educate and gain clinical knowledge that can be utilized to optimize DRG assignment and documentation. - Accurately updates HIM Statistics related to admission, discharges, code assignment, final CMI, and LOS data. - Keeps track of LOAs and updates DRG spreadsheet daily. - Consistently demonstrates the ability to promptly recognize, establish, and deal with issues. - Strives to meet daily deadlines and demonstrates good time management skills, and participates in special projects and studies as assigned. - Maintain a 90% accuracy rate on coding audits performed monthly. Five percent of discharges will be audited monthly. - Assistance with RAC and third-party audit reviews related to coding and documentation issues. - Identifies and works towards resolutions of problems with charts or physicians that can cause delays with coding and/or clinical care. - Takes initiative to self-educate on the latest federal, state, and accreditation guidelines related to HIM and coding. - Actively uses coding clinic and latest coding guidelines and conventions for accurate code assignment. - Utilizes and completes all 3M education coding modules for ICD-10. - Works closely with the facility to ensure administration, case management, and the liaisons are aware of all coding changes and documentation barriers. - Attends coding round tables, meetings, and in-services as assigned. - Performs other duties as assigned. Benefits
Outpatient III Coder
BJC HealthCareBJC HealthCare is one of the largest healthcare organizations in the U.S. focused on delivering "the world's best medicine," made better by its 30,000+ clinical
Role Description BJC is hiring for an Outpatient Coder III. This is a remote position. No previous coding experience is required. Training will be provided. - Must have one of the following certifications: RHIA, RHIT, CCS, CPC, CPC-A, CCA, or COC - Eligible remote states: - Alabama - Arkansas - Florida - Georgia - Illinois - Indiana - Iowa - Kansas - Kentucky - Louisiana - Mississippi - Missouri - North Carolina - Ohio - Oklahoma - South Carolina - Tennessee - Texas - Wisconsin Qualifications - High School Diploma or GED - Cert/Lic in Area of Expertise Requirements - No Experience - No Supervisor Experience Preferred Requirements - 2-5 years of experience Benefits - Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date - Disability insurance paid for by BJC - Annual 4% BJC Automatic Retirement Contribution - 401(k) plan with BJC match - Tuition Assistance available on first day - BJC Institute for Learning and Development - Health Care and Dependent Care Flexible Spending Accounts - Paid Time Off benefit combines vacation, sick days, holidays and personal time - Adoption assistance
• Submit accurate insurance claims via SimplePractice, verifying CPT codes, diagnosis codes, payer IDs, and fees prior to submission; monitor claim status on a bi-monthly cadence and process resubmissions, reconsiderations, and appeals as needed. • Generate and send invoices for deductibles, coinsurance, no-show fees, and private pay balances; follow up with patients on outstanding amounts and manage accounts escalated to collections per company policy. • Verify patient benefits including deductibles, coinsurance, and visit limits prior to billing; identify and communicate insurance red flags, ensure required agreements are signed, and track deductible accumulation. • Review EOBs to confirm payment accuracy, match payments to dates of service, and identify discrepancies; reconcile insurance payments against internal records and investigate mismatches or missing payments. • Identify cases where insurance payments are sent directly to patients and initiate follow-up via portal, SMS, or email to collect and apply outstanding payments; escalate unresolved cases as needed. • Maintain Admin Notes in SimplePractice, Trello tracking cards, and internal spreadsheets for audit readiness; manage pre-authorizations, pre-certifications, and auto accident workflows; communicate clearly with patients on coverage, billing responsibilities, and payment expectations.


