JOB.TITLE
Requisition #: req11143
Shift: Days
FTE status: 1
On-call: No
Weekends: No
General Summary:
The Billing and Reimbursement Coordinator serves as a leader in the billing area, and manages accounts receivable. This person serves as the department’s technical expert in his/her specialty area.
Requirements:
- Minimum high school diploma or equivalent combination of education and experience. Associates degree in accounting or business administration highly desired. Previous work experience of at one to two years of health care setting is strongly preferred. Certified Revenue Cycle Representative a plus.
- Must possess the technical and professional skills required in medical or hospital billing, including insurance verification and benefit determination, medical terminology as it relates to billing and understanding of the reimbursement cycle
- Must be proficient with computer functions, including ability to use automated systems for third party billing and insurance follow up
- Ability to work efficiently and effectively under tight deadlines, with interruptions and high work volume.
- Must possess thorough knowledge of HIPAA requirements regarding all job functions
- Ability to work independently with minimal supervision
- Good oral and written communication skills
- Ability to manage multiple requests and projects simultaneously
Essential Functions and Responsibilities:
- Responsible for Accounts Receivable for areas assigned, maintaining standards as set by director.
- Develops and maintains a body of skills and knowledge on hospital billing and reimbursement. Disseminates and/or trains staff on information
- Maintains knowledge of compliance regulation, standards and directives regarding governmental/regulatory agencies and/or third party payers.
- Responsible to maintain quality in billing and follow up for optimum performance in tracking and collecting reimbursement on accounts. Participates in interdepartmental projects including provider onboarding, practice and provider education, coding review and other special projects.
- Reviews claims daily, for accuracy and necessary attachments, utilizing electronic billing software.
- Identifies underpayments specific to contract language and working with contracting department.
- Maintains daily work queues according to payer requirements, including, late charges/credits, multiple visits in one day, 3-day rule, changes in insurance coverage, claim errors, payer denials and insurance follow up.
- Performs quality reviews and analysis to support internal controls and monitor employee performance.
- Provides staff training, coaching, support, issue identification, assessment, resolution and keeping the director apprised of the progress. Responsible for input in recruitment and corrective action decisions as well as performance evaluations.
- Responsible for oversight of daily operations within the assigned department. Meets quality and productivity standards established by management. May need to work additional hours (evenings/weekends) to achieve team goals. Provides coverage and support for other teams.
Category: Health Care, Admin & Clerical
