What are the responsibilities and job description for the Billing Coordinator position at MemorialCare Health System?
Description
Title : Billing Coordinator
Location : Long Beach
Department : Ambulatory Pharmacy Revenue Cycle
Status : Full Time
Shift : Days
Pay Range
- 25.71 / hr - $37.28 / hr
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare.Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability.Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork.
Position Summary
The Senior Billing Coordinator (SBC) for Infusion Care Pharmacies has responsibility for obtaining insurance authorization and reauthorization for service, verifying patient eligibility, reviewing billing for products and services, and insuring the maximum allowable payment for the services rendered. The SBC is also responsible for working with the clinical staff in contract negotiations with insurance companies and medical groups. The SBC also collects data and reports on the financial viability of the infusion pharmacy operations to the Billing Manager, Pharmacy Manager and Pharmacy Director. The SBC will be responsible for training staff and monitoring intake / authorization staff effectiveness.
Essential Functions and Responsibilities of the Job
1. Receives inbound faxes and physician orders for home infusion therapy. Handles inbound calls from Case Managers and Pharmacy regarding Intake orders. Prioritizes orders by importance based on discharge dates / times or urgency. Enters all patient demographics and physician order information accurately into patient account. Drug / formula calculations are done accurately. Asks for assistance from Pharmacy as needed.
2. Verifies eligibility with insurances, and documents findings in patient account. Patient paperwork showing responsibility and government required documents are prepared and given to patients timely. Reports patients without eligibility to Manager.
3. Obtains authorization for patient care. Follows up daily on pending authorizations to assure claim drops for billing as soon as possible. Reports any delays in authorizations to Managers.
4. Works in concert with other Intake Representatives to assure all work is current at the end of each work day.
5. Works with clinical staff and management to make recommendations for contract negotiations with insurance companies and medical groups. Identifies areas for greater reimbursement.
6. Performs other duties as assigned.
Qualifications
Qualifications - External
Experience
Education
Salary : $37
