Patient Account Coordinator – 40 hrs/wk – Billing

Job Summary: The primary functions for the Patient Account Coordinator are to recognize and execute all functions necessary to bill, collect, log and file insurance claims and payments. He/she must maintain and monitor the claims, and be able to communicate and resolve internal and external problems and issues relating to these claims.

Essential Duties:

1. Retrieve and work daily insurance lists (unapproved, approved and claims with missing information). Process claims appropriately on each list within 1 hour of receipt.
2. Retrieve generated claims for verification and mailing or electronic billings. Claims must be prepared and ready to mail within a 24 hour period.
3. Build electronic claims file for Commercial, Anthem, and Medicare, correcting edit list, transmission of claims, and receiving transmission report in the absence of others.
4. Recognize checks and remittances into the computer system. Receipts must be posted within two business hours of receipt. This includes changing collect codes, billing, secondary insurances, and processing credit balances.
5. Response to inquiries from patients. Internal and external requests for information must be completed within a 24-hour period.
6. Follow up of accounts that are unpaid. All claims should be on the billed and unpaid claims list under 60 days old or more recent column with proper notes. No claims should have a discharge date exceeding 4 months old from the current date. Any expectations must have appropriate documentation.
7. Respond to mail received. Mail should be opened and processed within a 24-hour period.
8. Do small balance adjustments. While working ageing and/or remittance advices all appropriate small balances must be adjusted.
9. Bill secondary insurances.
10. Responsible for Medicare Physician credentialing.
11. Review and verify total sheets for all other insurances
12. Prepare electronic transmissions, and transmit claims daily in the absence of others.
13. Train new employees as necessary.
14. Provide back-up for other insurance payers as appropriate.
15. Work with other departments to correct issues with Medicare APC edit list.

Education, Skills, Experience Requirements:

1. Minimum of as Associated Degree or equivalent experience preferred
2. Communication skills-ability to relate professionally with other hospital staff.
3. Type at least 30 words per minute with accuracy.