Account Resolution Coordinator

Children's Healthcare of Atlanta•Brookhaven, GA

About The Position

The Account Resolution Coordinator performs insurance claims billing and follow-up collections while meeting department performance expectations. The coordinator completes assigned work promptly, flags issues to the lead collector or patient accounts supervisor, identifies payer trends involving zero payments, payment variances, billing, and denials, and collaborates with other collectors. The role also completes projects requested by the patient accounts manager or supervisor and follows department and company policies.

Requirements

High school diploma or equivalent.
At least 1 year of experience in insurance billing or collections, with general knowledge of hospital business office functions.
Knowledge of third-party requirements and policies, including Medicaid, managed care, Blue Cross Blue Shield, care management organizations, HMOs, PPOs, commercial payors, and self-pay.
Excellent telephone communication and customer service skills.
Excellent written and verbal communication skills.
Familiarity with medical terminology, including diagnosis and procedure codes.
Ability to meet department and individual goals.
Ability to type 45 words per minute.
Ability to operate personal computer-based systems, including word processing, spreadsheets, and billing software.

Nice To Haves

Some college.
2 years of experience in insurance billing and/or collections, with general knowledge of hospital business office functions.
Knowledge of Children's Healthcare of Atlanta patient accounting applications, such as Epic Resolute, Dentrix Dental, or a clearinghouse, or a comparable system.

Responsibilities

Bill third-party insurance claims daily according to UB04 and HCFA 1500 guidelines.
Follow payer-specific billing requirements to help prevent claim denials and payment delays.
Prepare and submit final bill claims, secondary claims, rebills, and late charges daily, maintaining current status.
Follow up routinely on unpaid insurance claims and take appropriate action to resolve reimbursement delays.
Document telephone and written communications with third-party payors and guarantors through online activity codes.
Prioritize and proactively work accounts in the assigned work queue to ensure timely submission.
Comply with department workflows and routines.
Contact guarantors and other insured parties when additional information is needed and resolve reimbursement delays.
Process correspondence daily, including adding Medicaid eligibility to self-pay and commercial accounts.
Work returned mail on high-dollar accounts and correspondence from third-party payors.
Take appropriate action to resolve unpaid insurance, bad debt, and self-pay balances.
Meet department collection and follow-up performance expectations, complete assigned work promptly, and report obstacles to the lead collector or patient accounts supervisor.
Identify payer trends related to zero payments, payment variances, billing, and denials; collaborate with other collectors and lead collectors on claims billing and follow-up.
Complete projects as requested by the patient accounts manager or patient accounts supervisor and adhere to attendance, work requirements, and other policies.