at Cook County Government in Chicago, Illinois, United States
Job Description
Job Posting:Jul 3, 2024, 10:10:49 AMClosing Date:Jul 17, 2024, 11:59:00 PMFull-timeShift Start Time:8:00A.M.Shift End Time:4:00P.M.
Collective Bargaining Unit:AFSCME 1178Posting Salary:$24.410 HOURLY
Organization:Health and Hospital Systems
JOB TITLE: Third Party and Follow Up Representative
DEPARTMENT: Patient Financial Service
LOCATION: John H. Stroger Jr. Hospital
SHIFT: 8:00 AM - 4:00 PM
Job Summary AFSCME 1178
The Third-Party Billing and Follow Up Representative facilitates the billing and collection processes of outstanding accounts receivable. Analyzes claims to determine compliant and accurate coding, charging; reviews file to confirm demographic and billing information is updated.Makes recommendations to improve billing and collection practices in an effort to decrease the reimbursement timeframe and accuracy of payment.Processes legal requests for information; ensures proper authorization is on file to support the request.
Typical Duties
Facilitates the billing and collection processes of outstanding accounts receivable.
Communicates with internal and external contacts to explain primary, secondary and tertiary billing, collection and resolution of claims including Medicare and other government and non-government accounts.
Monitors daily queues for customer services/quality and productivity to maintain acceptable level as established by the departments, alerts management of high call volume patterns.
Handles incoming and outgoing billing correspondence and phone inquiries relating to patient, third party administrators, attorneys, vendors and other insurance payers.
Documents conversations and/or actions taken to support all claims inquiries, review and/or reconsiderations; streamlines the follow-up process of team members assisting on the file.
Analyzes claims to determine compliant and accurate coding, charging; reviews file to confirm demographic and billing information is updated.
Works to resolve any claim or billing concerns and takes appropriate action to escalate issues to management when appropriate.
Develops relationships with patients, third party administrators, attorneys, vendors and other insurance payers.
Performs follow-up processes on accounts to work towards a zero balance.
Files a timely reconsideration or review of claim with supporting documentation such as a corrected claim, medical records and letter of explanation as necessary; communicates with departments to gather information needed to resolve the claim.
Makes use of the software and hospital systems in accordance with hospital policies and procedures.
Performs account system updates such as changes to financial class, eligibility status, payor contact information or rebills.
Communicates with team members of any changes or updates that may impact workflow outcomes such as billing address or contact information.
Performs balance transfers.
Develops weekly productivity reports for management; makes recommendations to improve billing and collection practices in an effort to decrease the reimbursement timeframe and accuracy of payment.
Processes legal requests for information; ensures proper authorization is on file to support the request.
Maintains compliance with all billing and collections practices and regulations set forth by local and federal government and any other governing agencies to include but not limited to Center for Medicaid & Medicare Services (CMS), American Health Information Management Association (AHIMMA), Health Insurance Portability and Accountability Act (HIPAA), etc.
Completes annual education requirements.
Performs special projects and other duties as assigned.
Reporting Relationships
Reports to the System Supervisor of Third-Party Billing and Collections.
Minimum Qualifications
High School Diploma or GED (must provide proof at time of interview)
One(1)year of experience in hospital third party billing and account follow-up.
Current experience with a hospital revenue cycle system.
Preferred Qualifications
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, Skills, Abilities and Other Characteristics
Knowledge and familiarity with 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 any other 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 necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups.
Strong interpersonal and customer service... For full info follow application link.
COOK COUNTY HEALTH AND HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER