Medical Billing and Coding

• Perform day-to-day billing and follow-up activities for an assigned Patient Business Services location
• Support the revenue cycle process for government and non-government accounts
• Document claims billed, paid, settled, and follow-up activities in appropriate systems
• Identify and escalate issues affecting accurate billing and follow-up
• Contact payers directly regarding payments due on accounts
• Review and respond to mail correspondence accurately and promptly
• Communicate with hospital departments to clarify billing discrepancies and obtain demographic, clinical, financial, and insurance information
• Investigate overpayments, underpayments, credit balances, and payment delays
• Route tasks to appropriate workflows to maximize reimbursement and ensure timely claim payment or settlement
• Research claim rejections, make corrections, take corrective action, or refer claims for resolution
• Follow up with patients and third-party payers on delayed payments
• Prepare special reports as directed by the supervisor
• Train and educate Billing and Follow-up Representative I colleagues
• Provide problem resolution for billing and follow-up issues
• Perform other duties assigned by the supervisor
• Maintain knowledge of applicable laws, regulations, Trinity Health compliance programs, Code of Conduct, policies, and procedures
• Report directly to a Supervisor Billing & Follow-Up

Billing and Follow-Up Representative II – Specialty Acute Medical Billing

• Perform day-to-day billing and follow-up activities within the revenue operations of an assigned Patient Business Services location
• Support the revenue cycle process as part of the billing and follow-up team
• Document claims billed, paid, settled, and follow-up in appropriate systems
• Identify and escalate issues affecting accurate billing and follow-up activities
• Contact payers directly regarding payment due on accounts
• Review and respond to mail correspondence in a timely and accurate manner
• Communicate with hospital departments to clarify billing discrepancies and obtain demographic, clinical, financial, and insurance information
• Investigate overpayments, underpayments, credit balances, and payment delays
• Route tasks to correct workflows to maximize reimbursement and ensure claims are paid or settled timely and accurately
• Research claim rejections, make corrections, take corrective actions, and/or refer claims to appropriate colleagues
• Follow up on delayed payments by contacting patients and third-party payers, determining causes for delay, and supplying additional data as required
• Prepare special reports as directed by the Supervisor Billing and Follow-Up
• Perform other duties as assigned by the supervisor
• Maintain working knowledge of applicable laws, regulations, Trinity Health’s Integrity and Compliance Program, Code of Conduct, policies, and procedures

Billing & Follow-Up Representative, Hospital Medical Billing Follow-up – Commercial Payors

• Perform day-to-day billing and follow-up activities within the revenue operations of an assigned Patient Business Services location
• Support the revenue cycle process as part of the billing and follow-up team
• Document claims billed, paid, settled, and follow-up activities in appropriate systems
• Identify and escalate issues affecting accurate billing and follow-up
• Contact payers directly regarding payment due on accounts
• Review and respond to mail correspondence accurately and promptly
• Communicate with hospital departments to clarify billing discrepancies and obtain demographic, clinical, financial, and insurance information
• Investigate overpayments, underpayments, credit balances, and payment delays
• Route tasks to appropriate workflows to maximize reimbursement and ensure timely, accurate claim payment or settlement
• Research claim rejections, make corrections, take corrective actions, and refer claims to appropriate colleagues
• Follow up on delayed payments with patients and third-party payers, determine causes, and provide additional data as needed
• Prepare special follow-up reports as directed by the Supervisor Billing and Follow-Up
• Perform other duties assigned by the supervisor
• Maintain knowledge of applicable laws, regulations, Trinity Health’s Integrity and Compliance Program, Code of Conduct, policies, and procedures

Billing & Follow-Up Representative I – Hospital Medical Billing Follow-up – Commercial Payors

• Perform day-to-day billing and follow-up activities within revenue operations for an assigned Patient Business Services location
• Bill and follow up on government and non-government accounts
• Document claims billed, paid, settled, and follow-up activities in appropriate systems
• Identify and escalate issues affecting accurate billing and follow-up
• Contact payers directly regarding payment due on accounts
• Review and respond to mail correspondence in a timely and accurate manner
• Communicate with hospital departments to clarify billing discrepancies and obtain demographic, clinical, financial, and insurance information
• Investigate overpayments, underpayments, credit balances, and payment delays
• Route tasks to appropriate workflows to maximize reimbursement and ensure timely claim payment or settlement
• Research claim rejections, make corrections, take corrective actions, and refer claims as needed
• Follow up on delayed payments with patients and third-party payers
• Prepare special reports as directed by the Supervisor Billing and Follow-Up
• Assist with training and education of Billing and Follow-up Representative I colleagues
• Provide problem resolution for billing and follow-up issues
• Perform other duties assigned by the supervisor
• Report directly to a Supervisor Billing & Follow-Up

• Analyze each medical record to determine which items will be coded and abstracted
• Accurately code and abstract inpatient medical records according to work assignments and expected productivity standards
• Assign ICD10-CM diagnosis, ICD10-PCS procedure codes and CPT-4 procedure codes according to national and departmental guidelines and the AHIMA Code of Ethics
• Abstract and/or edit medical record data as required by departmental guidelines
• Assign and enter charges for ER evaluation and management levels, infusions, injections and procedures
• Communicate with physicians and Clinical Documentation Integrity Specialists to request clarification or additional record information
• Maintain an organized system for personal coding reference material
• Participate in educational activities and maintain coding skills

Senior Coder Abstractor – Inpatient

• Review medical record documentation and assign ICD-10-CM, ICD-10-PCS, MS-DRG, and APR-DRG codes
• Extract, review, analyze, and abstract clinical and facility-required data
• Translate clinical data into codes for hospital billing, POA and PSI indicators, research, statistics, financial planning, compliance, and marketing
• Verify patient discharge disposition and assign appropriate present on admission (POA) indicators
• Determine case complexity using clinical knowledge of diseases, procedures, diagnostics, treatment, and prognosis
• Research complex diagnoses and procedures to apply correct coding
• Capture principal diagnosis, co-existing conditions, and principal procedure for inpatient admissions
• Collaborate with CDI specialists and DRG compliance auditors to query providers and clarify documentation
• Sequence codes to accurately capture Severity of Illness and Risk of Mortality
• Follow official coding guidelines, AHIMA ethics, AHA Coding Clinics, CMS directives, and regulatory requirements
• Utilize Optum CAC according to established workflow
• Maintain coding accuracy, quality, productivity, and performance standards
• Attend required meetings, in-services, educational sessions, and annual learning programs

Medical Billing and Coding jobs in Michigan

Billing and Follow-Up Representative II – Specialty Acute Medical Billing

Billing & Follow-Up Representative, Hospital Medical Billing Follow-up – Commercial Payors

Billing & Follow-Up Representative I – Hospital Medical Billing Follow-up – Commercial Payors

Billing and Follow-Up Representative II – Specialty Acute Medical Billing

Senior Coder Abstractor – Inpatient

Inpatient Coder