Billing Coordinator

911

Remote?: 1

Highlights (Bonus, shift, relocation, info for job):

This role is responsible for managing the claims and billing processes, including assuring accurate and timely charge entry, timely clean claim creation and billing, aggressive and regular claim status follow-up via electronic and verbal communications. Monitor and handle claim rejections, denials, and denial management via appeals processing. Responsibilities also include individualized specialty focused tasks.

 

Duties and Responsibilities

• Possess a knowledge of State(s) and Federal billing and reimbursement guidelines, including third party insurance plans as well as changes in policies and procedures, contracts and fee-schedules as designated by the plan and/or the management for the practice.
• Responsible for the day-to-day billing operations, which includes but are not limited to the following:
• Review superbills ready for charge posting to ensure accuracy and proper coding practices
• Prepare and submit clean claims to third party payers either electronically via the assigned clearinghouse or by paper in a timely manner.
• Payer accepted claim report note:  Confirm claims receipt status with payer within seven business days of billing
• Work out of the designation work-queues as priority
• Identify claims not falling in work queues for reporting to Manager
• Work rejected and denied claims within the department guidelines and standards
• Start and continue bi-weekly claims status review with the payer
• Claims aged at 45 days and no adjudication status should be escalated to the payer claims adjudication manager.
• Escalate unpaid claims greater than 60 days of billing the manager for review and determination regarding further collection efforts.
• Review eob’s within five business day of posting activity for next billing action.
• Production and distribution of monthly patient statements (when applicable)
• Maintain and follow-up on patient payment plans (when applicable)
• Appeal denied claims with aggressive follow-up and resolution
• Manage denied claims via the Denial Management workflows
• Work with Front Office to ensure appropriate collection of any patient responsibility

• Retrieval of confirmation reports and verification of claims and statement submission

• Review and evaluation of billing reports for errors and trends, and suggest report to Manager
• Escalate unpaid claim greater than 60 days of billing the manager for review and determination regarding further collection efforts.

• Provide excellent customer service, educating patients regarding their plan provisions as well as answering questions from patients or providers related to insurance and billing.
  
  

Minimum Qualifications

• High School Diploma or equivalent required.
• Associated degree in HealthCare Administration or similar preferred.
• Minimum of 6 years Healthcare billing and collections required.
• FQHC billing and knowledge preferred.

Why Work at AbsoluteCare?

At AbsoluteCare, we serve the most vulnerable individuals in America. These are our neighbors, people who are at higher risk for disease or who have multiple, complex, chronic illnesses. Often, they deal with an unequal healthcare system and wind up seeking basic care from emergency rooms. We take these patients out of those spaces and turn them into members: people who are entitled to some of the best, most focused care this country has to offer. 

We call this “care beyond medicine.” We have turned the doctor’s office into a comprehensive care center. Here, we surround our members with a core care team of doctors, nurses, social workers, and medical assistants who have the time and skills to get to know our members’ needs. We make the most important services available to our members under one roof. This includes a pharmacy, X-rays, a blood lab, nutrition services, urgent care, and much more.

We don’t stop at our four walls. We engage members in the communities where we all live to find the people who need us most. Through these community care teams, we remove the barriers to healthcare that so many people face daily. And it works. 

Our unique care is guided by our core values of accountability, caring, trust, and teamwork. We call it ACT².

AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.

EEO Employer Verbiage: AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.