COORDINATOR, SPECIALIZED BILLING - PREADMISSION TESTING

Job Details

Description

Job Summary

Responsible for all aspects of Surgical services billing processes including billing compliance, implementation and maintenance of billing practices across the health system. Develops processes involving expedient exchange of information to and from clinical staff, clients and Business Office. Guarantees accurate, timely and consistent flow of the billing information and manual bills to all customers. Conducts follow-up to Business Office, physicians and patient registration issues. Develops and conducts compliance audits. Accurately and professionally resolves patient and billing problems to ensure appropriate payment reimbursement in a timely manner. Conducts and completes statistical analysis involving daily and monthly manual bills, reconciliation of failed billing report, etc. Working knowledge of surgical services and office, coaches staff in operational practices that effect billing, such as registration.

Essential Job Functions

• FISCAL ACCOUNTABILITY holds self-accountable for departmental processes in order to maintain successful flow of the revenue cycle and maximum reimbursement for services.
• Processes reports in a timely and accurate manner, guaranteeing consistent reporting of billing accounts.
• Monitors and analyzes appropriate reports to expedite the adjudication of accounts pended for edits, delayed for payment, or denied from a responsible party
• Maintains workable knowledge of patient charge processes in order to identify errors and areas to direct requests for proper corrective actions
• Maintains knowledge of billing compliance and regulations, monitors billing activities to assure compliance.
• Maintains knowledge base of all client contracts.
• Reviews and Purchase Services invoices for approval of payment.
• COMPLIANCE Maintains laboratory databases and practices to ensure compliance to current billing regulations and standards. Assesses practices for compliance and provides periodic reports.
• Assist in maintaining CDM for surgical area..
• Communicates compliance information and performance feedback to end users.
• Maintains a global view of all cardiovascular operations to assure updates to all appropriate areas.
• Monitors performance through audits and reports.
• OPERATIONAL PERFORMANCE. Influences and persuades others to build commitment toward operational excellence. Monitors performance.
• Acts as a role model for peers by striving for excellence, displaying a positive attitude, and actively supporting the team concept.
• Monitors and reports individual statistics to assist in the evaluation of outcome-based criteria set by Management, i.e., registration errors.
• Process analysis. Identify areas for performance improvement. Identify problematic areas and provide workable solutions to them.
• Maintains documentation of failed bills and monitors performance related to billing issues. Communicates to supervisor, manager and/or director concerning performance failures.
• Possesses functional knowledge of operations and billing systems cycle to assist in reducing unnecessary corrections to accounts.
• Provides constructive feedback and clearly expresses ideas.
• Communicates with management all issues that impact the accurate, timely and complete accomplishment of all assigned tasks.
• Identifies and communicates to supervisor recommendations for process improvements. Identifies a minimum of one workflow improvement annually.
• Successfully responds to customer issues (intradepartmental, interdepartmental and patient based) in a timely way. Maintains appropriate documentation to ensure a thorough record of actions taken and dispositions made.
• Works effectively with Operating Room & BI staff to coach and mentor operational practices that impact billing practices.
• Proficient in general computer software applications including Word, Excel, transcription and general office tasks
• Provide accurate reports and timely completion of assigned tasks to insure operations.
• Organizes and maintains files to assure timely retrieval. Examples include implants, worksheets & purchase orders.
• Reviews purchase orders in a timely manner.
• Monitors and manages timely patient's accounting
• Acts promptly to resolve accounts receivable in order to maximize reimbursement and reduce the aging of accounts.
• Reviews failed billing reports, processes adjustments and corrections daily
• Insures appropriate follow-up is taken whenever necessary to capture all reimbursement
• Customer Service
• Serves as a reliable point person for clients as relates to billing issues
• Maintains open communication with all clients.
• Computer skills. Maintains proficiency in all information systems
• Serves as a role model in all information systems that deal with scheduling, registrations, billing.
• Demonstrates excellent organizational skills, maintaining records and paper work in an organized and effective manner (Word, Excel)
• Consistently complies with billing updates and system changes
• Problem solving/Troubleshooting skills
• Performs thorough investigation of patient accounting errors to identify the root cause and make appropriate adjustments
• Monitor and troubleshoot all charging issues, including maintenance of various charging processes.
• Performs coverage (as appropriate) for answering phones & scheduling patients. Creating quick surgical accounts.
• Other duties as assigned.
  

Required Qualifications

• High School Diploma, GED or higher level of education.
• Related training/experience (preferably within the past five years).
• Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment.
• Strong ability to communicate complex and/or controversial topics and concepts to a wide and diverse audience.
• Basic Math and Keyboard Proficiency
• Functional Skills on PC and Related Software (Microsoft Office)
• Knowledge of basic Office Equipment such as copier, fax machine, etc.
• Ability to multi-task and prioritize assignments
• Basic working knowledge of computers and office equipment.
• Knowledge of Excel.
  
  

Preferred Qualifications

• Medical Terminology
• Knowledge of accounting or bookkeeping preferred.
• Knowledge of basic ICD-9 and CPT Coding.
• Knowledge of healthcare billing. Knowledge of insurance payors and benefits.
• Associate degree in applied science, medical secretarial.
  
  

License, Certification & Clearances

• Act 34-PA Criminal Record Check from the PA State Police system
  
  

Supervisory Responsibilities

• This position has no direct supervisory responsibilities, but does serve as a coach and mentor for other positions in the department.
  
  

Position Type/Expected Hours of Work

• Incumbents will be scheduled based on operational need (rotate shifts, standby, on-call, etc.).
• Travel may be expected locally between Independence Health locations.
  
  

Equal Employment Opportunity

Independence Health and its affiliated companies are Equal Opportunity Employers. It is their policy to prohibit discrimination of any type and to afford equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, marital status, disability, veteran status, or genetic information, or any other classification protected by law. Independence Health and its affiliated companies will comply with all applicable laws and regulations.

Disclaimer

This job description is not designed to contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee. Moreover, duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.

Work Environment

Effective March 2020 or during pandemic: goggles, face shield and mask are required according to CDC guidelines

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Essential – Absolute Necessity.

Marginal – Minimal Necessity.

Constantly – 5.5 to 8 hours or more or 200 reps/shift.

Frequently – 2.5 to 5.5 hours or more or 32-200 reps/shift.

Occasionally – 0.25 to 2.5 hours or 2-32 reps/shift.

Rarely – Less than 0.25 hours or less than 2 reps/shift.

Physical Condition

Essential

Marginal

Constantly

Frequently

Occasionally

Rarely

Never

Extreme Heat

x

Extreme Cold

x

Heights

x

Confined Spaces

x

Extreme Noise(>85dB)

x

Mechanical Hazards

x

Use of Vibrating Tools

x

Operates Vehicle (company)

x

Operates Heavy Equipment

x

Use of Lifting/Transfer Devices

x

Rotates All Shifts

x

8 Hours Shifts

x

x

10-12 Hours Shifts

x

x

On-Call

x

Overtime( 8/hrs/shift; 40/hrs/wk)

x

x

Travel Between Sites

x

x

Direct Patient Care

x

Respirator Protective Equipment

X

Eye Protection

X

Head Protection (hard hat)

X

Hearing Protection

X

Hand Protection

X

Feet, Toe Protection

X

Body Protection

X

Latex Exposure

x

x

Solvent Exposure

X

Paint (direct use) Exposure

X

Dust (sanding) Exposure

X

Ethylene Oxide Exposure

X

Cytotoxic (Chemo) Exposure

X

Blood/Body Fluid Exposure

X

Chemicals (direct use) Exposure

X

Mist Exposure

X

Wax Stripper (direct use)

X

Non-Ionizing Radiation Exposure

X

Ionizing Radiation Exposure

X

Laser Exposure

X

Physical Demands

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Essential – Absolute Necessity.

Marginal – Minimal Necessity.

Constantly – 5.5 to 8 hours or more or 200 reps/shift.

Frequently – 2.5 to 5.5 hours or more or 32-200 reps/shift.

Occasionally – 0.25 to 2.5 hours or 2-32 reps/shift.

Rarely – Less than 0.25 hours or less than 2 reps/shift.

Physical Condition

Essential

Marginal

Constantly

Frequently

Occasionally

Rarely

Never

Bending (Stooping)

X

Sitting

x

x

Walking

x

x

Climbing Stairs

x

x

Climbing Ladders

x

Standing

x

x

Kneeling

x

Squatting (Crouching)

x

x

Twisting/Turning

x

x

Keyboard/Computer Operation

x

x

Gross Grasp

x

x

Fine Finger Manipulation

x

x

Hand/Arm Coordination

x

x

Pushing/Pulling(lbs. of force)

x

<10#

Carry

x

<10#

Transfer/Push/Pull Patients

Seeing Near w/Acuity

x

x

Feeling (Sensation)

x

Color Vision

x

x

Hearing Clearly

x

x

Pulling/Pushing Objects Overhead

x

Reaching Above Shoulder Level

x

Reaching Forward

x

x

Lifting Floor to Knuckle

###

x

<10#

Lifting Seat Pan to Knuckle

###

X

Lifting Knuckle to Shoulder

###

X

Lifting Shoulder to Overhead

###

x

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.