Accounts Resolution Coordinator

Job 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.

Requirements

• 1 year of experience in insurance billing or collections, with a general knowledge of hospital business office functions
• Some college education
• 2 years of experience in insurance billing and/or collections, with a general knowledge of hospital business office functions

Qualifications

• Knowledge of key Children's Healthcare of Atlanta patient accounting applications, e.g., Epic Resolute, Dentrix Dental, Clearinghouse, or comparable system

Skills

• 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
• Excellent telephone communication and customer service skills
• Excellent written and verbal communications skills
• Familiar with medical terminology, including diagnosis and procedure codes

Benefits

Children’s Healthcare of Atlanta is an equal opportunity employer committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, color, sex, religion, national origin, citizenship, age, veteran status, disability or any other characteristic covered by applicable law.