Professional Billing Insurance Coordinator

Professional Billing Insurance Coordinator

Position Overview:
The Insurance Claims Coordinator reviews, handles and takes appropriate action on all unpaid third party insurance claims in excess of 30 days since file date, giving special consideration to large and/or older claims. He/She handles matters relating to account audits by insurance third party audit firms; works closely with insurance billers, medical records, registration, ancillary departments and business office personnel. The Insurance Claims Coordinator is responsible for follow up of designated insurance accounts, finalization of insurance matters, and audit matters regarding certain claims. 

DISCLAIMER:  This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this intends to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks performed as assigned.

Position Overview:
The Insurance Claims Coordinator reviews, handles and takes appropriate action on all unpaid third party insurance claims in excess of 30 days since file date, giving special consideration to large and/or older claims. He/She handles matters relating to account audits by insurance third party audit firms; works closely with insurance billers, medical records, registration, ancillary departments and business office personnel. The Insurance Claims Coordinator is responsible for follow up of designated insurance accounts, finalization of insurance matters, and audit matters regarding certain claims. 

DISCLAIMER:  This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this intends to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks performed as assigned.

Education:
High school graduate or equivalent required.

License:
N/A

Certification:
N/A

Experience:
A minimum of two (2) years’ patient accounting and insurance experience preferred.  Experience in a hospital or healthcare setting preferred.  

Reports to:
Director of Collaborative Care Network

Supervises:
None

Physical Demands:
Work is moderately active: involves sitting with frequent requirements to move about the office, move about the facility, and to travel to another facility within the SRHS service area.  Work involves exerting a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.  Work involves using repetitive motions: substantial movements of the wrists, hands and/or fingers while operating standard office equipment such as computer keyboard copier and 10-key.
Work involves being able to perceive the nature of sound at normal speaking levels with or without correction; the ability to make fine discriminations in sound. Work requires close visual and acuity and the ability to adjust the eye to bring an object into sharp focus, i.e. shift gaze from viewing a computer monitor to forms/printed material that are closer to compare data at close vision. Must be able to work for extended periods of time without experiencing undue fatigue.  

Mental Demands:
Must demonstrate keen mental faculties/assessment and decision making abilities.  Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone.  Must demonstrate strong written and verbal communication skills.  Must possess emotional stability conducive to dealing with high stress levels.  Must demonstrate ability to work under pressure and meet deadlines. Attention to detail and the ability to multi-task in complex situations is required.  Must have strong analytical and interpersonal skills.  

Special Demands:
Must possess superior customer service skills and professional etiquette.  Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.).  Must have intermediate knowledge of MS Outlook, Word, Excel, and PowerPoint.  Must possess knowledge of all Revenue Cycle functions in hospital settings and medical terminology; and, a thorough knowledge of state and federal laws, as they apply.  Experience navigating within an Electronic Medical Record (EMR).