Account Resolution Coordinator - Professional Billing

Children's Healthcare of Atlanta

About The Position

Meets all department collection and follow-up performance expectations. Completes assigned work in a timely fashion and reports any issues or obstacles to lead collector or patient accounts supervisor to ensure swift resolution. Identifies payor trends proactively in relation to zero payment, payment variance, billing, and denials. Works closely with other collectors and lead collectors in completing claims billing and follow-up collection activities. Completes projects as requested by patient accounts manager or patient accounts supervisor. Adheres to company and department attendance, basic work requirements, and other policies and procedures.

Requirements

1 year of experience in insurance billing or collections, with a general knowledge of hospital business office functions
High school diploma or equivalent
Knowledge of third-party requirements and policies, including Medicaid, Managed Care, Blue Cross Blue Shield, care management organizations, health maintenance organizations, preferred provider organizations, commercial payors, and self-pay
Must have excellent telephone communication and customer service skills
Excellent written and verbal communications skills
Familiar with medical terminology, including diagnosis and procedure codes
Must be able to meet department/individual goals
Must be able to type 45 words per minute
Must be able to operate personal computer-based systems, including working knowledge of word processing, spreadsheet, and billing software

Nice To Haves

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

Responsibilities

Performs daily billing of claims to third-party insurance following the guidelines of the UB04 and HCFA 1500 manual.
Ensures that special billing needs by payor are performed to prevent denial of claims and delay in payment.
Prepares and submits all final bill claims, secondary claims, rebills, and late charges on a daily basis, maintaining a current status.
Performs routine follow-up on unpaid insurance claims, taking appropriate action to resolve problems causing delay in reimbursement.
Documents all telephone and correspondent communications with third-party payors and guarantors thoroughly via online activity codes.
Prioritizes and works proactively on accounts in assigned work queue to ensure all accounts are submitted in a timely manner.
Complies with department workflows and routines.
Contacts guarantors and other insured parties when additional information is needed and takes appropriate action to resolve any delay in reimbursement.
Works correspondence daily, including adding Medicaid eligibility to self-pay and commercial accounts.
Works returned mail on high-dollar accounts and correspondences from third-party payors.
Takes appropriate action to resolve all insurance, bad debt, and/or self-pay unpaid balances.