Note: The job is a remote job and is open to candidates in USA. Children's Healthcare of Atlanta is a children's healthcare provider seeking an Account Resolution Coordinator - Professional Billing. The role performs insurance claims billing, follow-up collections, payment issue resolution, and account documentation while meeting department performance expectations.
Responsibilities
- Performs daily billing of claims to third-party insurance following the guidelines of the UB04 and HCFA 1500 manual
- Ensures that special billing needs by payor are performed to prevent denial of claims and delay in payment
- Prepares and submits all final bill claims, secondary claims, rebills, and late charges on a daily basis, maintaining a current status
- Performs routine follow-up on unpaid insurance claims, taking appropriate action to resolve problems causing delay in reimbursement
- Documents all telephone and correspondent communications with third-party payors and guarantors thoroughly via online activity codes
- Prioritizes and works proactively on accounts in assigned work queue to ensure all accounts are submitted in a timely manner
- Complies with department workflows and routines
- Contacts guarantors and other insured parties when additional information is needed and takes appropriate action to resolve any delay in reimbursement
- Works correspondence daily, including adding Medicaid eligibility to self-pay and commercial accounts
- Works returned mail on high-dollar accounts and correspondences from third-party payors
- Takes appropriate action to resolve all insurance, bad debt, and/or self-pay unpaid balances
Skills
- 1 year of experience in insurance billing or collections, with a general knowledge of hospital business office functions
- High school diploma or equivalent
- Knowledge of third-party requirements and policies, including Medicaid, Managed Care, Blue Cross Blue Shield, care management organizations, health maintenance organizations, preferred provider organizations, commercial payors, and self-pay
- Must have excellent telephone communication and customer service skills
- Excellent written and verbal communications skills
- Familiar with medical terminology, including diagnosis and procedure codes
- Must be able to meet department/individual goals
- Must be able to type 45 words per minute
- Must be able to operate personal computer-based systems, including working knowledge of word processing, spreadsheet, and billing software
- Some college
- 2 years of experience in insurance billing and/or collections, with a general knowledge of hospital business office functions
- Knowledge of key Children's Healthcare of Atlanta patient accounting applications, e.g., Epic Resolute, Dentrix Dental, Clearinghouse, or comparable system
Company Overview
Company H1B Sponsorship