Ambulatory Coordinator - Billing Specialist

Midland Health•Midland, TX

11d

About The Position

Responsible for the billing and collections of physician claims. This position will file physician claims for reimbursement, including electronic and paper submissions. Monitor physician systems, billing and patient accounting system, department reports, taking corrective action to ensure accuracy in claim filing to payers. The Ambulatory Coordinator I will function in accordance with federal, state, and local laws; rules and regulations; and policies, procedures and guidelines of the employing health care institution or practice setting. This position is also responsible for consistent commercial insurance follow-up of physician claim(s) greater than 30 days, aged from final bill date, and resolution of same in a timely and cost-effective manner. This requires forming relationships with the individual insurance payers/clients in order to have the maximum response for timely and accurate payment. Monitor patient accounts assigned for accurate payment(s) or non-payment and take compliant actions for account reimbursement.

Requirements

High School Graduate or Equivalent
Two (2) years billing or coding experience preferred

Responsibilities

Resolution of all billing claims; electronic and manual
End of month reporting and distribution of reports to contracted physicians
Able to understand, explain and handle referral/authorization issues, pre-authorization requirements, verifications, appeals, and medical necessity issues
Timely follow up of claims including the completion of additional tasks to assure claims are paid timely
Ability to respond timely to insurance and billing inquiries made in person, by mail or over the phone
Completion of all billing edits
Awareness, knowledge and cognitive ability in use of 1500 form locators, ICD 9 codes, CPT codes, and modifiers

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