Job Summary

Responsible for overseeing the billing and collection processes of a healthcare organization. They ensure that the claims are submitted accurately and timely, and that the payments are received and reconciled. They also supervise and train the billing staff, monitor the performance and compliance of the billing department, and resolve any issues or disputes with payers, patients, or providers.

Essential Functions

• Submit claims electronically or by mail to insurance companies, government agencies, or other payers

• Follow up on unpaid or rejected claims or account inquiries to resolve any issues or discrepancies.

• Monitor claim status and ensure timely and accurate reimbursement.

• Review and verify patient information, diagnosis codes, procedure codes, modifiers, and charges for accuracy and compliance.

• Follow up on denied claims and make necessary corrections or appeals.

• Maintain accurate and confidential records of billing transactions and documentation.

• Update and verify patient demographics, insurance information, and eligibility.

• Report and resolve any discrepancies, errors, or irregularities in billing processes.

• Communicate professionally with patients, providers, and insurers to address billing questions and disputes.

• Process payments, adjustments, refunds, and write-offs.

• Collaborate with other areas within revenue cycle, operations, and shared service areas to address and prioritize work efforts.

• Prepare and send statements and invoices to patients or responsible parties.

• Prepare and analyze reports on the billing, reconciliation, and collection activities, and identify and address any trends, issues, or opportunities for improvement.

• Ensure compliance with the policies and procedures of the organization, as well as the regulations and standards of the industry and the payers.

• Mentor, train, and evaluate the billing staff, and provide feedback and guidance on their performance and development.

• Handle complex or escalated billing and collection issues, and communicate effectively with payers, patients, providers, and other stakeholders.

• Stay updated on the changes and developments in the healthcare billing and coding field.

• Prepare and provide education and training to the billing staff and the providers.

• Coordinate with support teams to conduct and validate technology functions with respect to upgrades, optimizations., and new systems.

• Prepare and present information in a group setting

Qualifications

Required

• Required High School Diploma or equivalent.

• 5 years of relevant experience Patient Financial Services.

Preferred

• Associate’s Degree.

• CRT-Revenue Cycle Representative, Certified (CRCR) - HFMA Healthcare Financial Management Association.

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

• Optional identity theft protection, home and auto insurance, pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Royal Oak Hospital - 3601 W 13 Mile Road - Royal Oak

Department Name

Oncology Administration - CH East

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

Variable

Days Worked

Monday to Friday

Weekend Frequency

N/A

CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.