Coordinates various tasks of the Insurance Services area of the Business Office. Provides support for Manager and Revenue Cycle Director in the coordination of daily workflow. Interacts in a professional manner with patients, payers, physicians, and other medical center personnel. Provides accurate statistical records and reports. Proactive in the area of problem solving and works to ensure quality performance of business functions throughout the department.
1. Assists employees engaged in the daily tasks of the Insurance Services area of the Business Office (to include claims, correspondence, follow-up, record storage, etc.). Ensures efficient coordination of workflow.
2. Is available to answer questions for Business Office Staff, other medical center departments, and patients.
3. Provides management with weekly status reports regarding issues and accomplishments of the Department.
4. Assists with the development of new procedures and implements them as approved or requested by the Manager and/or Director.
5. Provides on-going practice management training as needed.
6. Attends workshops and meetings as requested by the Manager or Revenue Cycle Director.
7. Answers the Insurance Coverage Team ACD line as needed.
8. Provides training and updates to branch campuses regarding procedural changes, etc., as needed. Travels to branch campuses for on-site training as requested.
9. Oversees the claims process and ensures accurate claims are mailed within 2 days of receipt.
10. Monitors Workqueues and reports to ensure clclaim errors, rejections, and denials are worked regularly to guarantee remittance of payments.
11. Assists in the insurance follow-up process, assuring reports are worked accurately and timely, appeals are accomplished, etc. Provides support as specific needs are identified to decrease department backlogs.
12. Assists the insurance coding area as needed to keep the Workqueues current (coding within 48 hours of receipt). Provides feedback to Scheduling and Registration Manager as needed for staff education.
13. Assists with timecards for Insurance Services staff, making corrections as needed by established deadlines when manager is out of the office. Assists the department Manager in reviewing staff time off requests.
14. Responsible to keep current with insurance billing requirements and changes by reading payer newsletters and other publications.
15. Coordinates special A/R clean-up projects as requested by management.
16. Performs monthly insurance audits.
17. Assists with Patient Service questions/emails.
18. Performs other tasks as requested by the Manager or Revenue Cycle Director.
19. Assists in the removal/voids of procedures that were billed incorrectly.
20. Performs other tasks as requested by the Manager or Director.
Demonstrate Standards of Behavior and adhere to the Code of Conduct in all aspects of job performance at all times.
- High school diploma or GED.
- Proficient in the performance of basic math functions.
- Possesses basic computer (e.g., spreadsheets, word processing) skills.
- Must be a team player.
- Maintains a positive, resourceful attitude toward achieving overall department and clinic goals.
- Related post high school courses.
- Previous supervisory experience.
- Knowledge of ICD-10, CPT coding, medical terminology, and insurance billing.