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Accounts Receivable Coordinator

Work Schedule/Days:  Day / Monday - Friday
Employment Type:  Full-Time
Location:  Support I 
Requisition #:  89224

 

JOB SUMMARY

Responsible for timely and accurate insurance billing and follow up on claims submitted.  Assesses account information and acts as appropriate to obtain expected payments on patient accounts.  Contacts third-party payors via telephone and online to determine action needed to ensure obtain appropriate reimbursement for professional Children’s Healthcare of Atlanta services rendered.  Completes assigned work in a timely fashion and reports any issues or obstacles to AR Coordinator and   supervisor. Collaborates with others in the department to coordinate claims submission and follow-up activities. Meets all department insurance collection and follow-up performance expectations. Completes projects as requested by department leaders.

EDUCATION

  • High school diploma or equivalent

CERTIFICATION SUMMARY

  • No professional certifications required

EXPERIENCE*

  • One year of experience in health care insurance claim resolution, with a general knowledge of patient accounting functions

PREFERRED QUALIFICATIONS*

  • Some college
  • Two years of experience working to resolve health care patient accounts receivable
  • Experience with including Epic Resolute, nThrive electronic claims management , or comparable systems
  • Familiarity with medical terminology and provider diagnosis and procedure coding

KNOWLEDGE SKILLS & ABILITIES*

  • Demonstrated critical thinking and problem solving skills with the ability to identify claim payment and resolution issues 
  • Knowledge of health care claim requirements and policies, including Medicaid, Medicaid, Care Management Organizations, and  commercial managed care payors.
  • Excellent telephone communication and /customer service skills.
  • Excellent written and verbal communications skills
  • Able to meet department/individual goals and performance expectations Able to operate personal computer-based systems, including working knowledge of Microsoft Office products

JOB RESPONSIBILITIES*

  1. Performs submission of claims to third party payors consistent with payor guidelines
  2. Identifies carrier special billing requirements and works to ensure claims meet those requirements to prevent denial of claims and delay in payment. Performs follow-up on unpaid insurance claims, using phone calls and online portals as appropriate to resolve accounts receivable balances.
  3. Identifies root cause payor denial or variance trends and takes appropriate actions to resolve
  4. Identifies payor trends proactively in relation to payment variance, billing, and denials.
  5. Documents all communications with third-party payors and guarantors thoroughly via Epic Resolute
  6. Documents and escalates signifant and recurring issues to department leadership, as well as with third party payor representatives.
  7. Prioritizes and works proactively on accounts in assigned work queue to ensure all accounts are resolved in a timely manner.
  8. Complies with department workflows and routines.
  9. Contacts guarantors and other insured parties when additional information is needed to submit a claim or obtain payment as expected. Takes appropriate action to resolve and escalate any delays in reimbursement.
  10. Works correspondence daily as assigned to resolve claim processing issues and documentation requirements.
  11. Works returned mail as assigned to resolve any address or other demographic issues preventing resolution of account balances.
  12. Adheres to company and department attendance, basic work requirements, and other policies and procedures. 

 

SYSTEM RESPONSIBILITIES*

Safety: Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system.

 

Compliance: Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Maintains records of compliance activities and reports compliance activities to the Compliance Office.

 

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification.  They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.

PHYSICAL DEMANDS*

Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance
Bending/Stooping - Occasionally (activity or condition exists up to 1/3 of time)
Climbing - Not Present
Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.
Lifting - Occasionally (activity or condition exists up to 1/3 of time)
Pushing/Pulling - Occasionally (activity or condition exists up to 1/3 of time)
Sitting - Frequently (activity or condition exists from 1/3 to 2/3 of time)
Standing - Occasionally (activity or condition exists up to 1/3 of time)
Walking - Occasionally (activity or condition exists up to 1/3 of time)

WORKING CONDITIONS*

No potential for exposure to blood and body fluids

 

Address:  1575 Northeast Expressway, Bldg 1, Atlanta, GA  30329 
Function:  Revenue Cycle - Patient Financial Services


Nearest Major Market: Atlanta

Job Segment: Medical, EMR, Medicaid, Healthcare