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Patient Account Billing Coordinator I
2 months ago
The Healthcare Billing Specialist is tasked with a variety of responsibilities within the Accounts Receivable reconciliation framework. Key duties include: meticulously reviewing, amending, and regularly updating Patient Health Information to guarantee precise insurance billing and payment follow-up; electronically submitting claims to payers utilizing the designated claims management software; analyzing rejected claims within the billing software to refine and resubmit them to the payer to prevent denials; applying suitable contractual and self-pay adjustments; addressing inquiries from patients and insurance providers; liaising with physician offices as needed to secure authorizations or inform them of medically unnecessary diagnostic orders; utilizing online systems from various payers to confirm eligibility and benefits, as well as monitoring claim statuses; maintaining consistent and appropriate documentation for accounts managed; employing sound account management principles to ensure accurate billing; identifying non-payment patterns by payer and alerting management; working towards productivity goals set by management for the daily submission of validated claims; making necessary account corrections to ensure timely payment of claims, regardless of departmental responsibilities; printing and dispatching medical records and itemized statements for payers that require paper claim submissions; and, if required, contacting patients or employers to verify health insurance or workers' compensation details to ensure timely and accurate claim submissions. The role demands a high level of professionalism and effective communication when collaborating with other departments within the business office or revenue cycle to facilitate timely and accurate billing.
Key Responsibilities
- Manage the billing process for patient accounts, which includes reviewing, correcting, and consistently updating health insurance claims to ensure prompt payment and follow-up.
- Address inquiries from patients and insurance carriers regarding billing within the revenue cycle.
- Utilize online systems from multiple payers to verify eligibility and benefits, and appropriately check claim statuses.
- Engage with payers via telephone to investigate denial trends in billing, ensuring that claims are submitted in a 'clean' manner.
- Maintain accurate and consistent documentation on accounts processed within the patient accounting systems.
- Review memos related to accounts in patient accounting systems for all reprinted or rebilled claims, ensuring necessary updates are made prior to submission to the payer.
- Identify non-payment trends by payer and notify systems coordinators and management to adjust billing tables for accurate billing or timely adjustments, aiming to reduce accounts receivable days.
Minimum Education
- High School Diploma or Equivalent Required
- 6 months of relevant experience in the revenue cycle (including patient access, financial assistance, insurance billing, patient and/or insurance collections, reimbursement, customer service, payer contracting, or coding) Required
- Experience in healthcare insurance billing Preferred
Baptist Health Care is a not-for-profit healthcare organization dedicated to enhancing the quality of life for individuals and communities in northwest Florida and south Alabama. The organization encompasses three hospitals, four medical parks, the Andrews Institute for Orthopaedic & Sports Medicine, and a comprehensive network of primary and specialty care providers. With a workforce exceeding 4,000 team members, Baptist Health Care stands as one of the largest non-governmental employers in northwest Florida.
