The Medical Billing Coordinator role is full-time, 8:00 AM to 4:30 PM, Monday through Friday.
The Medical Billing Coordinator position requires a professional who is organized and detail-oriented. This role communicates effectively, both with patients and families and with the HSK team.
The Medical Billing Coordinator will be a valued member of the HSK Team and will have immediate access to fellow team members.
Job Title: Billing/Accounts Receivable Coordinator
Experience: 1-3 years (preferred)
FLSA: Exempt
FTE Status: Full time
Education Level: Assoc. / Bach Degree and/or 2 – 3 Yrs. experience
Reports to: Director of Operations
Job Summary
Procuring funds from patient’s payor sources. He/she must be meticulous and tenacious in pursuing payment, with dedicated follow-through. It also, requires some creative thinking outside the box to explore potential leads for possible payment sources.
ROLE
The Billing/Accounts Receivable Coordinator (BARC) role requires the ability to multi-task in a fast-paced environment, strong team and customer service skills, technical expertise, and solid communication skills. In this role, the BARC must demonstrate solid problem-solving skills and independent action abilities. The BARC is responsible for a variety of billing functions, including insurance follow-up, claims resolution, accounts receivable management, and responding to staff, patients, and payers in a timely manner with a high level of customer service and a positive attitude.
RESPONSIBILITIES (not all-inclusive)
Under general direction, the BARC is responsible for the production and quality of billing services provided for claims submitted to federal, state, and third-party insurance carriers; performs billing, collection, and follow-up activities to maximize reimbursement; maintains service orientation to management members and clinical staff for hospice and physician billing services; manages the patient accounts, performs analysis and reporting for accounts receivable; provides training and quality control feedback for clinical staff involved in point of care data entry with tablet or laptop computers in the field.
Accurately processes insurance payments and electronic remittance files and reconciles to patient accounts.
- Processes electronic and paper claims and submits to payer or clearinghouse with necessary attachments and documentation to support the claim.
- Maintains account receivables by following up on outstanding claims.
- Responds to phone calls and works effectively with insurance companies and patients regarding billing procedures, balances and statements. Researches information concerning write-offs and adjustments and makes recommendations to the Executive Director for resolution.
REQUIREMENTS – SOME SPECIFIC DUTIES (Not all-inclusive)
- Precerts (pre-certifications) & Preauths (pre-authorizations) on all new patients for hospice eligibility.
- Reauthorizations for all patients prior to expiration of current benefit periods and always before their next benefit periods.
- Data entry of all required information into billing and collections systems to accomplish clean claims for all service billings.
- Hospice Services
- Physician Services/Visits
- Nurse Practitioner (NP) Services/Visits
- Room & Board Charges for Nursing Homes
- Other services and charges as may occur
- Recording collections of all monies and adjustments by patient account from EOB’s to maintain consistent integrity of account balances in systems.
- Timely investigation and research to determine what corrective actions are necessary to resolve any and all billing errors on all denied claims.
- Implement necessary corrections to resubmit denied claims and collect monies as quickly as possible.
- Follow-up on all denied claims that have been resubmitted and work the claims to avoid timely billing denials.
- Document all billing adjustments with explanations and present to Director of Finance or Executive Director for approval prior to posting adjustments to the system.
- Document all billing denials with explanations and post adjustments to the system.
- Reports and Documentation needed:
- Aging report Write-off report (Must include written reasons for each write-off)
- Face to Face report (Visits needed for the upcoming month)
- Recerts report (All recerts needed for the upcoming month)
- CAHPS report
- Claims submitted thru KHN – copies sent to KHN
- Pharmacy list collected and added to claims with Medicare
- KLOCS – Medicaid for SNF Patients, enter MAP forms, follow thru for approval
- Responsible for billing families/primary responsible party for residential room and board at the Hospice House.
RESULTS
- Billing: To maintain success in this position, the BARC must process clean claims by accurately submitting bills with an error rate of less than 5%.
- Collections: To maintain success in this position the BARC will need to be aware of all claims that have a balance over 90 days and work diligently to get them paid.
RESULTS (cont.)
To maintain success in this position, the BARC must process and collect all claims in an effective method to maintain adjustments and write-offs within industry standards.
Any and all adjustments or write-offs must have the prior approval of the Executive Director.
RELATIONSHIPS
Building positive workplace relationships is vital for career success. Relationships can positively or negatively affect your ability to accomplish your job, satisfaction with the job, or advance and gain recognition for your achievements. When you build positive relationships, you feel more comfortable with your interactions with others. You feel a closer bond to the people you spend the majority of your time working with.
This position is a customer service position that requires traits of compassion, fair-mindedness and firmness. In order to develop and build positive relationships to ensure positive outcomes in collecting money on accounts outstanding, the person in this position must maintain positive and productive interactions with your supervisor, staff and team members, senior management, vendors, clients, customers, any direct reports and directors.
Building positive relationships often provides increased resources to help you get your job done and to be more efficient. You’ll enjoy greater satisfaction at work… and so will those around you.
PHYSICAL DEMANDS and WORKING CONDITIONS
Requires sitting for long periods of time; occasional bending, stretching or lifting. This position requires the ability to work under high stress conditions for long periods of time. Ability to hear normal range of voice, drive, and negotiate steps, walkways or housing not designed for handicap access. May require contact with individuals with communicable disease. Able to work in normal office environment, use office equipment, and prepare written reports.