1. High School diploma or GED.
2. Minimum of one (1) year experience in the collection of medical accounts.
3. Knowledge of payer guidelines, medical billing and medical coding.
4. Familiar with PC, Windows, Word, and Excel.
5. Experience with verification of home health benefits preferred.
6. Knowledge of medical terminology.
7. Excellent oral communication skills.
Job Description Summary:
An Accounts Receivable Coordinator must be detail-oriented and have excellent follow-up skills. They must be able to communicate well with others both verbally and in writing. This person must be able to understand, interpret, and follow various payer guidelines and the guidelines of the Accounts Receivable Department.
Essential Job Functions/Responsibilities:
A. Verifies home health benefits.
B. Communicates relevant patient information to the appropriate nursing office and/or insurance company as needed.
C. Negotiates service rates with insurance case managers as needed.
D. Communicates pertinent information to insurance case managers in order to receive approval for home health visits.
E. Completes insurance verification forms and sends to the appropriate nursing offices and billing department.
F. Obtains clinical updates on patients from the nursing offices and notifies insurance company of the patients’ progress.
A. Insure the accurate and timely submission of claims per established billing guidelines.
B. Correct and resubmit claims returned with errors.
C. Insure the accuracy and completeness of insurance information received on a daily basis. Review and confirm all data and back up documentation.
D. Insure that after-billing adjustments are completed in an efficient and timely manner.
E. Maintain patient confidentiality at all times. Become familiar with the Patient Bill of rights and respect the rights of all CareSouth Customers and co-workers.
A. Research assigned accounts for reasons on non-payment, errors in payment or incorrect payment postings by appropriate method and action.
B. Communicate and follow-up with payers and other guarantors on a regular basis to determine current status of accounts.
C. Respond to callers or correspondence regarding questions or problems with statements, invoices, or previously submitted claims in a timely manner.
D. Identify accounts requiring outside collection services according to departmental guidelines. Insure all internal actions have been exhausted.
E. Insure that all collection activities are thoroughly documented including, but not limited to dates, parties contacted with phone numbers or addresses, actions taken, results, and follow-up necessary.
F. Create and/or maintain billing and collections files in a timely fashion.
G. Complete billing adjustments affecting Accounts Receivable following departmental guidelines and submit to Supervisor in a timely manner.
H. Secure office, patient billing and collection charts after hours as outlined in CareSouth policy and procedure.
I. Develop work habits that insure a safe working environment for all CareSouth co-workers.
J. Keep informed on all changes in procedures or guidelines affecting timely submission and payment of claims. Attend all staff meeting or in-service educational programs as deemed necessary by Departmental Supervisor.
K. Perform other duties as assigned by Supervisor. Assist other employees whenever possible.
CareSouth - 10 months ago