Reimbursement Coordinator II- Self Pay

Responsibilities

• Process billing and/or authorizations for all financial classes including Commercial, Federal, and State plans, as assigned, ensuring confidentiality of patient billing information and HIPPA compliance.
• Obtain and track claim or authorization status via online portals and via phone.
• Compose and follow up on claim appeals.
• Identify, address, submit or process adjustments, over payments and outstanding balances, as appropriate.
• Review of Insurance Explanation of Benefits to facilitate account resolution.
• Allocate co-insurance and deductible appropriately within the Cerner system, as appropriate.
• Review and address incoming mail correspondence.
• May provide assistance and support regarding charity care guidelines to SRA Lab physicians and hospital operational leadership.
• May meet with patients and families as needed regarding financial assistance/charity care program.
• Ensures compliance with insurance payer guidelines.
• Perform all other duties that may be assigned in the best interest of the Shirley Ryan AbilityLab.

Requirements

• Reporting relationship: Manager Customer Service, Patient Financial Services
• Knowledge, Skills & Abilities Required:
• Educational level appropriate with what is typically gained through the acquisition of a High School Diploma. Associates degree preferred.
• Minimum 3 years of experience with hospital billing and/or collecting from health insurance carriers.
• Knowledge of governmental billing regulations preferred.
• Previous experience with insurance collections, appeals, follow-up in hospital setting.
• Familiar with UB-04 and HCFA 1500 billing regulations, as appropriate.
• Ability to build relationships with insurance carriers and representatives.
• Understands business implications of decisions.
• Maintain all production standards as outlined for assigned work.
• Ability to keep up to date with insurance billing regulation changes as assigned.
• Ability to quickly learn to bill specific financial classes/Payors as assigned.
• Previous experience with functions and responsibilities associated with coordination of charity preferred.
• Excellent verbal and written communication skills.
• Ability to perform basic mathematical functions.
• Bilingual (Spanish) preferred.

Working Conditions

• Normal office environment with little or no exposure to dust or extreme temperature.