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Insurance Coordinator

4 months ago

Menomonee Falls, United States Tech Observer Full time

Title: Insurance Coordinator

Duration: 3 months

Essential Duties:

-Responsible for supervision and oversight of the daily operations of Patient Financial Services inhouse insurance follow-up functions and related staff.

-Assists staff in determining work priorities and ensures staff is successfully completing job functions.

-Maintains appropriate staffing levels in the department to ensure excellent customer service and meet departments goals.

-Assesses and justifies need for additional or replacement staff.

-Monitors work queues of respective areas and reassigns staff or redistributes workload as needed.

-Monitors quality and productivity metrics and holds staff accountable for stated goal targets.

-Responsible for providing guidance, training, support and solutions to Insurance Follow-Up staff.

-Works closely with management, staff and other areas to continuously provide and improve service.

-Responsible to ensure and maintain effective resource utilization for assigned area.

-Monitors and trends payer performance and presents findings at Provider Representative meetings.

-Implements action plans with staff to reverse negative accounts receivable trending.

-Monitors and understands denial patterns and provides training and feedback on appropriate denial resolution.

-Escalates denial patterns to Provider Representatives of respective payer.

-Monitors interactions with other departments and third party payors to improve productivity and efficiency and provide exceptional customer service.

-Works closely with clinical departments and other revenue cycle departments on cross functional issues affecting billing, coding, registration and reimbursement.

-Develops, reviews, updates, and implements department policies and procedures on a continual basis.

-Prepares and updates payer reference materials.

-Assists with training staff on policies and procedures.

-Researches and maintains knowledge of policy/procedures of all agencies/third party payers.

-Makes changes to established protocol consistent with agency/payer policies/procedures changes in order to maximize revenue.

-Maintains and initiates changes or additions to the department computer systems, including work listing functions.

-Shares in planning for and communicating change involving other departments and troubleshooting to minimize potential conflicts.

-Selects, motivates, directs, and develops staff to cooperatively achieve departmental goals.

-Hires, terminates, counsels staff and takes personnel action, when necessary, per *** & Community Health personnel policies.

-Motivates employees to be productive, positive, contributive member of the team and encourages employees to think without limitations when problem solving.

-Prepares and administers objective annual performance evaluations for staff, based on a set of pre-determined measures or standards, monitored by department head review."


Required Skills & Experience:

-Five years' experience in billing, customer service or collections in a healthcare environment is required.

-Three to four years' leadership experience is required.

-Demonstrated skills in planning, directing organizing and implementing projects.

-Recent experience in healthcare reimbursement and knowledge of medical coding and billing.

-Problem solving and well-developed analytical skills required.

-Effective written and verbal communication skills.

-Well-developed personnel management and leadership experience.

-Experienced user in Excel and Word.