Billing Follow Up Rep I

Full-time, benefits-eligible position (40 hours per week). Remote work available.

About the role

Support moderately complex processes related to billing, coding, and reimbursement. Actively follow up with insurance carriers on open insurance claims. Ensure complete and timely revenue collection from patients and third-party payers through accurate entry and correction of patient, charges, and insurance information. Verify daily electronic claim submission.

Responsibilities

• Independently review accounts and apply billing follow-up knowledge required for all insurance payors to ensure proper and maximum reimbursement.
• Use multiple systems to resolve outstanding claims according to compliance guidelines.
• Perform pre-billing, billing, and follow-up activity on open insurance claims using revenue cycle knowledge (e.g., CPT, ICD-10, HCPCS, NDC, revenue codes, and medical terminology).
• Obtain necessary documentation from various resources.
• Communicate timely and accurately with internal teams and external customers (e.g., third-party payors, auditors) and act as a liaison to validate and correct information.
• Comprehend incoming insurance correspondence and respond appropriately.
• Identify and escalate patterns/trends related to coding, compliance, contracting, claim form edits/errors, and credentialing that may delay or deny reimbursement.
• Stay updated with insurance payer changes, single case agreements, and assist management with recommendations for implementation of edits/alerts.
• Accurately enter and/or update patient/insurance information into the patient accounting system.
• Appeal claims to ensure contracted amounts are received from third-party payors.
• Comply with and maintain KPIs (Key Performance Indicators) for assigned payers within departmental and insurance guidelines.
• Compile information for referral of accounts to internal/external partners as needed.
• Maintain clear, accurate, online documentation of all billing and follow-up activity for each account using established guidelines.
• Read and understand all Advocate Aurora Health policies and departmental collections policies and procedures.
• Demonstrate proficiency in the proper use of software systems employed by Advocate Aurora Health.
• Escalate unusual, unreasonable, or inaccurate account information to a supervisor for approval or final disposition, including write-offs according to corporate policy.

Requirements

• High School Diploma or General Education Degree (GED).
• Typically requires 1 year of related experience in a medical/billing reimbursement environment, or an equivalent combination of education and experience.
• Must perform within the scope of departmental guidelines for productivity and quality standards.
• Ability to work independently with limited supervision.
• Basic keyboarding proficiency.
• Ability to operate computer and software systems in use at Advocate Aurora Health.
• Ability to operate a copy machine, facsimile machine, and telephone/voicemail.
• Proficiency in reading, writing, speaking, and understanding English.
• Ability to read and interpret documents such as Explanation of Benefits (EOB), operating instructions, and procedure manuals.

Preferred Qualifications

• Knowledge of medical terminology, coding (CPT, ICD-10, HCPC), and insurance/reimbursement practices.
• Understanding of contractual relationships.

Skills

• Strong communication skills to obtain information via telephone or in person.

Pay

Pay range: $20.80 - $31.20 per hour.

Benefits

• Paid Time Off programs.
• Health and welfare benefits, including medical, dental, vision, life, short-term, and long-term disability.
• Flexible Spending Accounts for eligible health care and dependent care expenses.
• Family benefits such as adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match and other financial wellness programs.
• Educational Assistance Program.
• Base compensation within the listed pay range based on qualifications, skills, relevant experience, and/or training.
• Premium pay such as shift differential, on-call pay, and more based on the role.
• Incentive pay for select positions.
• Opportunity for annual increases based on performance.