Patient Representative Coordinator| Baldwin

American Addiction Centers•Milledgeville, GA

1d•Onsite

About The Position

The Patient Representative Coordinator provides direct supervision to Patient Account Representatives II and III in the Patient Business Office. This role involves analyzing accounts receivable volume fluctuations, making staffing recommendations within budget, and assisting staff and management in researching complex billing issues. The coordinator uses knowledge of hospital services, third-party billing, credit and collection laws, and computer systems to oversee billing, collection, and posting activities, ensuring timely resolution of accounts. They monitor productivity, ensure compliance with policies, review quality audits for trends and training opportunities, and collaborate with the Quality Control Analyst and Manager on staff training. The position also participates in hiring, training, corrective action, motivation, and provides orientation for new employees, ensuring continuing education requirements are met. Input is provided for staff evaluations, and the coordinator participates in departmental improvement discussions. They notify appropriate staff of new issues, denial trends, and reimbursement challenges, and collaborate with the Revenue Management Department and Governmental Denial Coordinator to resolve Medicare and/or Medicaid claims reimbursement issues. Ensuring timely rebilling of audited claims and providing input for governmental payor audits are key responsibilities. The role requires staying updated on insurance billing and reimbursement regulations, interpreting Medicare provider education, and adjusting billing practices accordingly. The coordinator must gain and exhibit appropriate financial knowledge, understand the impact of processes on Accounts Receivable, and grasp the financial calculations used to monitor the Patient Business Office's success. Regular monitoring of the work area for potential employee hazards and reporting safety concerns are also required. The coordinator assists the Manager with special projects and job responsibilities as defined by management and attends developmental opportunities to enhance work skills and personal growth.

Requirements

Must be CPAR or obtain certification within 2 years of obtaining position.
Requires a high school diploma or GED.
Minimum of 4 years of experience in accounting, insurance, collections or other related field.
Education may be substituted at a ratio of one year of education equal to 2 years of experience.
Communicates effectively, both verbally and in writing.
Exhibits leadership and problem solving skills.
Must be proficient in utilizing personal computers.

Nice To Haves

Bachelor’s Degree or higher preferred but not required.

Responsibilities

Provides direct supervision to the Patient Account Representative II’s and III’s in the Patient Business Office.
Analyzes fluctuations in accounts receivable volume and makes appropriate recommendations for adjustments in staffing within department budget parameters.
Assists the staff and management in researching complex billing issues utilizing the UB editor, Medicare and Medicaid coding manuals and the Patient Business Office billing manuals and other resources as appropriate.
Conducts research, complex analysis and follow-up on insurance claims, performs rebills and reprints as necessary, performs bad debt write-offs, charity write-offs and enters contractual adjustments as necessary, and/or posts payments in a timely manner.
Uses knowledge of hospital services and cost of services, third-party billing requirements, rules of subrogation and coordination of benefits, credit and collection laws, and computer system functions in performing job duties.
Oversees the billing, collection and/or posting activities of the staff and ensures timely resolution of accounts.
Monitors productivity and ensures compliance with policies and procedures.
Holds staff accountable for productivity standard.
Reviews quality audits, looking for trends and training opportunities.
In collaboration with Quality Control Analyst and Manager, provides training to the staff when needed.
Reviews audit results with each team member on a regular basis.
Participates in hiring, training, corrective action and motivation of staff as needed.
Provides orientation for new employees and ensures continuing education requirements are satisfied.
Provides input to the Manager for all staff evaluations.
Participates in weekly discussions with Manager related to departmental improvement opportunities.
Notifies appropriate staff of new issues, denial trends and other reimbursement challenges.
Collaborates with Revenue Management Department and Governmental Denial Coordinator to address and resolve Medicare and/or Medicaid claims reimbursement issues.
Ensures any claims audited by RMD are rebilled in a timely manner.
Provides input to the response to any governmental payor audits or reviews.
Stays abreast of all insurance billing and reimbursement regulations by reading all updates from the applicable payers in a timely manner and reacts as appropriate to avoid any compliance issues.
Reads and interprets Medicare provider education articles and GHP web banner messages as they are published.
Changes billing practices based on changes in regulations.
Gains and exhibits appropriate financial knowledge.
Understands the significance and impact processes have on Accounts Receivable.
Understands the financial calculations used in monitoring the success of the Patient Business Office.
Regularly monitors work area for potential employee hazards.
Reports all safety concerns to the Prevention and Control Officer.
Assists Manager with other special projects, reports and job responsibilities as defined by management as needed.
Attends developmental opportunities that further enhance work skills, personal growth and development.

Benefits

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program