Job Summary:

The incumbent is responsible for coordinating the revenue cycle process for the Allen Division of Medicine. This position will take the required actions in order to facilitate payment from the appropriate insurance payer for all inpatient and outpatient services rendered by the physicians within the Division. This individual in this role will also work to ensure that billing practices are ethical and in compliance with government regulations and guidelines.

Job Responsibilities:

• Coordinate billing processes for Allen Division of Medicine.
• Monitor charges and ensure they are entered promptly by divisional inpatient and outpatient providers.
• Run ‘Missing Charge Reports’ and other ad-hoc billing reports as needed.
• Coordinate onboarding of new physicians with department credentialing team and PEG to make sure they are credentialed appropriately and listed accurately in EPIC billing areas.
• Make deposits of co-pays and other payments when received for Allen outpatient practices.
• Manage templates builds and edits in EPIC.
• Act as a point of escalation and monitor and work supervisory or secondary work queues.
• Research and review insurance denials from insurance companies and work on complex denials as required.
• Inform divisional leadership of issues and possible trends observed when reviewing WQ’s and reviewing denial reports so appropriate action can be taken.
• Follow up with insurance companies regarding claims when necessary.
• Ensure account balances are correct and balances are assigned to the appropriate insurance or patient bucket. Process adjustments or transfers as needed.
• Resubmit corrected claims with supporting documentation as appropriate.
• Complete and submit reconsideration requests or appeals to insurance companies.
• Answer questions from patients and third-party payers regarding accounts.
• Document all follow up activity in EMR.
• Review payer reports making sure all accounts are paid appropriately.
• Regular interaction and investigation of patient accounts in our practice management and EHR software.
• Work with difficult insurance payers to ensure payments.
• Act as divisional point person with Departmental Revenue Cycle Team.
• Attend Revenue Cycle and other divisional meetings.
• Serve as a resource for the divisional faculty and practice support staff when questions relating to the billing and collection process arise.
• Perform related duties as assigned.

Job Qualifications:

• High school graduate or GED certificate is required, bachelor’s degree preferred.
• A minimum of 2 years’ experience in a physician billing or third-party payer environment required.
• Candidate must demonstrate the ability to understand and navigate contracts, insurance benefits, exclusions, and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.
• Ability to work independently with minimal supervision.
• Candidate must have comprehensive knowledge of medical terminology and coding (CDT and ICD-10 codes).
• Working knowledge of contracts, insurance benefits, exclusions, and other billing requirements.
• Experience with insurance verification, authorizations, denial management, etc.
• Previous experience with direct patient contact/coordination/scheduling.
• Candidate must demonstrate strong customer service and patient-focused orientation and the ability to understand and communicate insurance benefits explanations, exclusions, denials, and the payer adjudication process.
• Must demonstrate effective communication skills both verbally and written.
• Intermediate proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook).

Hourly Rate Range: $27.40 - $36.06

Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.

61st Street Service Corporation

At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.

We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.