Case Rate Coordinator

Fred Hutchinson Cancer Center•Seattle, WA

6d•Onsite

About The Position

The Case Rate Coordinator works directly with partner organizations and Case Rate Insurance vendors to assure that payments are received accurately and timely. Prepares payments to disburse to partner organizations and outside providers. Answers case rate related questions. Identifies and provides patient information for Accounting department to process correctly for General Ledger.

Requirements

High school graduate or equivalent
Minimum one year of experience with Medical Billing and payment or or equivalent coursework.
Minimum one year of experience with payment reconciliation related work or equivalent coursework.
Minimum one year of customer service related experience, including payer relations, inter-departmental, and partner communications.
Ability to use a computer keyboard and mouse, navigate computer programs, and use email in a business setting.
Ability to communicate verbally in person, on the phone, and in writing in a clear and concise manner.
Strong working knowledge experience with Micro Soft Office Suite, including Outlook, Excel, Access Database.
Attention to detail and ability to analyze large sets of number related data.
Identify and make recommendations regarding system issues.
Ability to understand and meet performance standards.

Nice To Haves

Understanding of billing edits and ability to resolve/or make recommendations.
Working knowledge of Case Rate and what it means when involving billing.
Understanding of billing edits and ability to resolve/or make recommendations to resolve any billing related issues.
Experience using Epic HB and Prelude Registration.
Experience in Revenue Cycle working with contract related billing.

Responsibilities

Maintain knowledge and understanding of Case Rate Contracts and IMTX Single Case Agreements with bundle language.
Manage case coverages and Transplant Billing Terms in Epic Bundle Episodes for case rate patient population.
Maintain open communication with inner-departmental staff including Intake, Financial Clearance, and Transplant Transition RN’s.
Notify partners of active cases and work with partners, including answering questions throughout case to closure.
Coordinate case period claims from all partners with balances to bill.
Manage Patient and claims information in Access Data Base.
Validate bundle package and create Invoice.
Submit Case Rate Bundles for claims processing either electronically or via Fed Ex.
Monitor cases and work with payers resolving any claims issues or payment disputes until payment is received.
Reconcile accounts and ensure all claims have been paid according to contract.
Distribute funds to Fred Hutch Accounts and to partners for their claims included in Case Rate billing.
Refund any case payment related over-payments to responsible payers.
Manage BCHP monthly billing and work with King County until payment is received.