Billing Follow Up Rep Lead

Department: 13464 Enterprise Revenue Cycle - PB Billing Support Operations

Status:

Benefits Eligible:

Hou rs Per Week:

Schedule Details/Additional Information:

Starting Monday - Friday 6:30a-3p or 7a-3:30p however position is flexible.

Pay Range:

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 to the appropriate payer source. Communicates with internal and external parties to resolve charging issues affecting the claims. Reports trends with other departments that may improve the claims submission process.
• May be responsible for collection of an assigned section of the insurance receivables, following all procedures and guidelines established.
• Reviews assigned accounts and takes appropriate course of action: internal or external problems that may cause a delay in reimbursement.
• Responds to telephone or written correspondence from internal and external parties regarding insurance claims. Applies contractual allowances where necessary.
• Assists team with more complex issues to resolve problems, provides necessary training, and provides ongoing feedback on performance.
• Monitors and audits productivity, quality and analyzes daily statistics looking for any trends which are reported to management. May provide feedback to Billing Rep I and II.
• Attends and participates in meetings as required, attend outside seminars and be used as “train the trainer” . Share training knowledge with others as appropriate.
• Keeps abreast with insurance payor updates/changes and assists management with recommendations for implementation.
• Prioritize rejections to avoid timely filing insurance appeal limitations, may include denials.
• Accountable to assess and resolve advanced projects as assigned. Research/Distribute new upgrades/information from the Insurance Payers re: Contracts, guidelines, reimbursement rules and regulations and for computer systems.

MINIMUM EDUCATION AND EXPERIENCE REQUIRED

• Level of Education: High School Diploma or General Education Degree (GED)
• Years of Experience: Typically requires 5 years of related experience in medical/billing reimbursement environment, or equivalent combination of education and experience.

MINIMUM KNOWLEDGE, SKILLS AND ABILITIES (KSA )

• Proficient in all follow up rep functions.
• Demonstrated ability to work and solve billing / follow up issues in a healthcare environment.
• Broad and comprehensive knowledge and understanding of department-specific procedures.
• Strong analytic, organization, communication (written and verbal), and interpersonal skills.
• Ability to successfully lead, coach, and train a team, and problem solve complex accounts.
• Knowledge of medical terminology, coding terminology (CPT,ICD- 10,HCPC), and insurance/reimbursement practice.
• Able to use Zoom, Microsoft office, or other communication software for meetings.

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:

Compensation

• Base 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

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, and Short- 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

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.