Account Resolution Coordinator

Children's Healthcare of Atlanta•Brookhaven, GA

18d

About The Position

The Account Resolution Coordinator meets department collection and follow-up performance expectations and completes assigned work promptly. The role identifies payer trends related to zero payments, payment variances, billing, and denials, and works with collectors and lead collectors on claims billing and collection follow-up. The coordinator reports issues or obstacles to the lead collector or patient accounts supervisor and completes projects requested by the patient accounts manager or supervisor. The position follows company and department attendance requirements, work standards, policies, and procedures. Responsibilities include daily third-party insurance claim billing, preparing and submitting final, secondary, rebilled, and late-charge claims, and routine follow-up on unpaid claims. The coordinator documents communications, works assigned account queues and correspondence, contacts guarantors or insured parties for information, and takes action to resolve delays and unpaid insurance, bad-debt, or self-pay balances.

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, with 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 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

Meet department collection and follow-up performance expectations and complete assigned work in a timely manner.
Identify payer trends involving zero payments, payment variances, billing, and denials.
Work with other collectors and lead collectors on claims billing and collection follow-up.
Complete projects requested by the patient accounts manager or patient accounts supervisor.
Perform daily billing of claims to third-party insurance according to UB04 and HCFA 1500 manual guidelines.
Meet payor-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.
Thoroughly document telephone and written communications with third-party payors and guarantors using online activity codes.
Prioritize and proactively work accounts in the assigned 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.
Work 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.
Follow company and department attendance requirements, work standards, policies, and procedures.