About The Position

As an experienced Claims Coordinator, you will work in a fast-paced, rapidly growing environment where you will be relied on for your expertise, professionalism, and collaboration. We are looking for a dedicated Claims Coordinator, focusing on accounts receivable activities, to join our team to support our Enterprise team. This role will have a significant emphasis on customer relations. You must be comfortable interacting, communicating, and working directly with patients.

Requirements

  • 3-4+ years of health plan / medical insurance accounts receivable experience in a fast-paced, customer-focused environment, with fertility clinic experience a plus
  • Strong written and verbal communication skills & a team player
  • Willingness to be flexible, roll with the punches, multi-task and troubleshoot problems
  • Detail-oriented with strong organizational skills
  • Exemplifies amazing customer service skills and professionalism
  • Experience in CPT and ICD-9 coding; familiarity with medical terminology
  • Ability to manage relationships with various insurance payers
  • Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.
  • Intermediate experience in Microsoft Excel
  • Certificate from an accredited medical and billing school.

Nice To Haves

  • Experience in the employer benefits space is a plus
  • A passion for women’s health, and fertility is a plus

Responsibilities

  • Ensure and manage timely follow up on all unpaid claims utilizing monthly aging reports
  • Effective communication abilities for phone contacts with insurance payers to resolve issues
  • Demonstrate customer service skills for interacting with patients regarding medical claims and payments
  • Oversee and perform research to resolve any discrepancies, denials, rejections, collections
  • Manage and set up patient payment plans and work collection accounts
  • Review patient bills for accuracy and completeness and obtain any missing information
  • Oversee and manage the posting of payments.
  • Oversee and process insurance payments, including balance billing to secondary insurance and/or directly to patients.
  • Analyze rejected and outstanding claims, troubleshoot errors and rejection codes, and correct and re-submit all denied claims.
  • Properly note the system and maintain all documentation required for compliant claim submission.
  • Respond to a high volume of inquiries in a positive and professional manner, resolve and follow up on all issues within designated timeframes.
  • Meet positional metrics and benchmarks.
  • Maintain the highest degree of ethics when handling patient payments and bill processing
  • Follow all department standard operating procedures carefully and accurately
  • Other duties as assigned by supervisor.
  • Manage inbound customer communication (phone, email & chat) and ensure all messages are answered in a timely fashion
  • Maintain clear communication and collaborate with stakeholders across the Enterprise team
  • Other duties and projects as assigned
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