Location: Green Bay,WI, USA
The Accounts Receivable Coordinator position is responsible for medical insurance claims with a heavy focus in AR management, coding, coding documentation and as well as any other business office projects assigned. Also oversees AR for federal programs.
Essential Functions:
* Works with CFO, Accountant and Billing Manager to facilitate accurate accounting records in QuickBooks.
* Maintains information on billing procedures by client.
* Prepares and submits clean claims to insurance companies/counties/private pay etc.
* Researches and resolves client billing issues with insurance companies/counties/private pay etc. Monitors reimbursement rates from insurance companies.
* Communicates client status of receivables when requested. Create financial reports in relations to accounts receivable function and status of accounts.
* Follows and reports on status of delinquent accounts; has plan for collection and aggressively pursues. Documents work performed / action taken on Accounts Receivable Aging Report.
* Performs various collection actions including contacting insurance companies and resubmitting claims to the third party payers.
* Reviews weekly aged receivables report for accounts that require follow-up.
* Follows all insurance regulations.
* Daily posting of EOBs to patient accounts and ISR forms.
* Daily follow-up of claims, including resolution of any billing errors.
* Reviews patient information to determine why the claim is unpaid.
* Obtains additional information needed to appeal denied or underpaid claims.
* Processes rejections and denials to determine if the claim needs to be refilled or submitted for an appeal with the payer.
* Processes all Payer appeal requests within the time frame required by the payer
* Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
* Excellent oral, written and interpersonal communications skills
* Audits patient accounts in practice management system and update as necessary, process refunds as needed.
* Perform documentation and coding audits to ensure compliance with Medicaid and other insurance guidelines.
Non-Essential Functions/Other Duties:
* Performs any other tasks assigned by management
Supervisory Responsibility: Not applicable.
Travel Required: Minimal.
Physical Demands:
This is largely a sedentary role, with frequent sitting and computer keyboarding (10-key) required. Some lifting (up to 35 pounds), stooping and bending are required.
Qualifications:
Education:
* High school diploma or equivalent.
* Prefer coursework and/or experience in medical and/or health insurance billing, medical records management.
Experience:
* At least two years of previous medical insurance, billing, or claims processing related experience.
* Comprehensive understanding of accounts receivable in a healthcare setting
* Strong understanding and experience in billing processes and appeals.
* Working knowledge of managed care plans, insurance carriers, referrals and pre-certification procedures
* Strong knowledge of ICD-10, CPT, HCPCS, modifiers and coding documentation guidelines. CPT and ICD-10 certification a plus.
Skills and Competencies:
* Strong keyboarding and computer skills to include MS Office (Word and Excel) experience at an intermediate level. 10-key data entry proficiency.
* Knowledge of medical coding and third-party operating procedures and practices as well as knowledge of financial concepts.
* Experience working with basic office machinery and equipment, including computers, copiers, fax machines, multi-line phone systems, etc.
* Knowledge of HIPPA privacy and security rules and regulations.
* Excellent interpersonal skills, with the ability to communicate effectively with others.
* Strong organizational skills, with the ability to multi-task and meet deadlines.
* Demonstrates initiative, with the ability to manage self and workload.
* Strong analytical and problem solving abilities. Good mathematical aptitude.
* Exemplary customer service focus, for both internal and external clients.
* Able to work both independently and be self-directed, as well as being able to perform in a team atmosphere.
* Displays professionalism and represents organization in a professional manner.
* Ability to abide by ethical guidelines and policies, including strict adherence to confidentiality and HIPPA guidelines.
Other:
* Must be 18 years old or older.
* Every Caravel employee is expected to maintain Confidentiality, Integrity, and availability (CIA) with reference to PHI and PII data of patients, parents, employees, and vendors. It is the responsibility of each individual employee to protect and inform data breaches immediately to the Security & Compliance Officer's.
* If any of the CIA policies are not adhered to, action will be initiated as per HR policy.
Caravel Autism Health reserves the right to modify, interpret, or apply this Job Description in any way the company desires. This job description in no way implies that these are the only duties to be performed by the employee. This job description is not an employment contract, implied or otherwise. The employment relationship remains At Will .