Medicaid Coordinator $2500 Sign On Bonus

ACCOUNT RECEIVABLE COORDINATOR

Job Description

New Season

Employee Name:? ?? Reports to: Account Receivable Supervisor

Department: Revenue Cycle FLSA: Non- Exempt Direct Reports: 0

Job Summary:

This position reviews known denial activity, whether electronically-generated or via paper, and reviews those denials, identifying the core issue involved (claims, account, secondary, enrollment, etc.). This position then takes action to correct the known denial activity as well as take steps to prevent similar denials from occurring. Due to the complexity of denial prevention, this position will often identify cases and refer those to senior leadership to partner on solutions to denied claims

Essential Functions:

• Identifies accounts that are denied from health plans.
• Responsible for creating correct invoices and updated statements on a proper schedule.
• Edits failed payments in the clearinghouse system(s) and make the appropriate system updates to the host database so that data integrity is preserved.
• Reconcile and resolve all discrepancies ensuring all activity is posted to the respective accounts.
• Follow up on unpaid claims in a timely manner, and report problem accounts to the Account Receivable Supervisor.
• Monitors claims and requests for documentation on a weekly basis to determine additional action.
• Assists intake with authorizations and obtaining physician orders.
• Oversees and adjudicates the rebilling of claim forms when required and doing so according to the rebilling policy in effect on the day that service is rebilled.
• Assist with approving and creating new customer accounts, this will include running credit checks on applicants, setting up terms for billing, and choosing credit limits.
• Maintain files of deposits, bank receipts, and customer records.
• Efficiently and consistently review all invoices.
• Process customer adjustments
• Keeps lines of communication open with the Clinic Operations Team to ensure individualized goals are met.
• Adheres to the service policy and principles of CMG/ New seasons.
• Other duties as assigned.

Supervisory Responsibilities:

(This position will supervise non-exempt staff in support roles performing duties described in "Essential Functions".)

None.

Essential Qualifications:

(To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the competencies (minimum knowledge, skill, and ability) required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions).

Education/Licensure/Certification:

The position requires a high school diploma or GED.

Required Knowledge:

The ideal candidate is familiar with healthcare claims data and the Revenue Cycle components necessary to generate claims. Also familiar with 837 claim form formats (1500 and UB) and with common terminology for denied claims and will have been trained on zero pay items in accordance with the department's training tool for the same.

Experience Required:

This position requires a minimum of 1-year experience in healthcare roles where they have been associated with claim data and claim production, as well as account follow up and denial processing.

Skill and Ability:

The ideal candidate is familiar with the healthcare environment and the Revenue Cycle components that lead to claim generation and payment, as well as account follow up.

Physical Demands/Work Environment:

(The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

Finger Dexterity:

Use primarily for writing, operating calculator, telephone, keyboard and other office equipment.

Talking:

Ability to communicate with patients and fellow employees.

Hearing:

Ability to hear normal conversations and receive ordinary information.

Vision:

Average, ordinary, visual acuity necessary to observe patients and work on the computer. Clear vision at 20 inches or less and distant vision at 20 feet or more.

Physical Strength:

Sedentary work; sitting most of the time. Exerts up to 10 pounds of force occasionally.

Working Conditions:

(The working conditions described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

• Ability to operate in an open work area with moderate everyday noise.

Core Competencies:

? Approachability

? Change Management

? Communication (Oral)

? Ethics/Values/Integrity

? Influencing/Persuading

? Listening

? Problem Solving

? Strategic Planning/Thinking

Mental Activities:

(The mental activities described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

Reasoning Ability:

Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form. Ability to maintain confidentiality.

Mathematics Ability:

Basic mathematics skills required.

Language Ability:

Be able to communicate fluently in English, second language proficiency helpful.

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