Reimbursement Coordinator II - Dallas, Texas

Sonic Healthcare USA•Dallas, TX

4d•Onsite

About The Position

We're not just a workplace - we're a Great Place to Work certified employer! Proudly certified as a Great Place to Work, we are dedicated to creating a supportive and inclusive environment. At Sonic Healthcare USA, we emphasize teamwork and innovation. Check out our job openings and advance your career with a company that values its team members! In this role you will: Understand all aspects of the billing system to properly perform job responsibilities. Follow-up on outstanding A/R balances in a timely manner. Manage assigned accounts related to denials, claim rejections and unprocessed claims. Review payer correspondence and respond accordingly. Research denied claims thoroughly to determine proper resolution. Use proper appeals/reconsideration protocol specific to each health plan as required to further collections’ efforts. Research payer policies to ensure proper processing and resolution of denied claims and/or appeals. Contact insurance companies as needed for appeals/reconsideration status on outstanding appeals. Perform necessary adjustments as outlined by payer contracts and management. Ensure claims are processed according to network requirements and in alignment with ProPath’s contracts. Identify payer trends related to reimbursement issues, denial patterns, payment discrepancies, etc. to ensure quick resolution and maximize revenue. Back-up Patient Call Center as needed to ensure patient/client calls are handled in a timely and professional manner. Adequately meet and/or exceed monthly collections and productivity goals as identified by management. Work special projects as needed. Maintain confidentiality of employee, patient, client and company records and issues in accordance with HIPAA guidelines. Communicate effectively with all levels of management, co-workers, patients and clients to provide quality customer service. Special projects and other related duties as assigned. Provide quality internal and external customer service.

Requirements

Minimum 3 years medical billing experience required, specifically related to account receivable and denials management.
High School diploma or equivalent.
Basic knowledge of CPT/ICD-10 and HCPCS codes, modifiers and CMS 1500 professional claims processing required.
Ability to effectively communicate orally and in writing with payers.
Knowledge of Medical Insurance claim processing a must.
Familiarity with Microsoft software including Excel, Word, and Outlook.
Incumbent must be detail oriented and have the ability to coordinate several projects simultaneously.

Nice To Haves

Some college helpful.
Pathology billing experience a plus.
Familiarity with Medicare guidelines helpful.

Responsibilities

Understand all aspects of the billing system to properly perform job responsibilities.
Follow-up on outstanding A/R balances in a timely manner.
Manage assigned accounts related to denials, claim rejections and unprocessed claims.
Review payer correspondence and respond accordingly.
Research denied claims thoroughly to determine proper resolution.
Use proper appeals/reconsideration protocol specific to each health plan as required to further collections’ efforts.
Research payer policies to ensure proper processing and resolution of denied claims and/or appeals.
Contact insurance companies as needed for appeals/reconsideration status on outstanding appeals.
Perform necessary adjustments as outlined by payer contracts and management.
Ensure claims are processed according to network requirements and in alignment with ProPath’s contracts.
Identify payer trends related to reimbursement issues, denial patterns, payment discrepancies, etc. to ensure quick resolution and maximize revenue.
Back-up Patient Call Center as needed to ensure patient/client calls are handled in a timely and professional manner.
Adequately meet and/or exceed monthly collections and productivity goals as identified by management.
Work special projects as needed.
Maintain confidentiality of employee, patient, client and company records and issues in accordance with HIPAA guidelines.
Communicate effectively with all levels of management, co-workers, patients and clients to provide quality customer service.
Provide quality internal and external customer service.