Posted on January 27, 2016 · Posted in Accounting & Finance, All Postings, Medical

If you are interested in applying for this position, please email your resume to beth@sedonastaffing.com. Include in the subject line “Special Accounts Coordinator”. Due to the volume of resumes received, any emails received without the proper subject will not be considered.

One of the Nation’s most respected Non-Profit, Pediatric Hospitals is currently hiring a Special Accounts Coordinator. This is a great opportunity to work for California’s largest Children’s Hospital. This position is temp to hire and will be based on candidates performance, and manager discretion.

Requirements:

  • 5 years of experience in commercial follow up and denials.
  • Intermediate-advance level of MS Office programs; vlookup/pivot table in Excel.
  • Knowledge of EPIC (not required will train)
  • Knowledge of account balances for commercial, government, & managed-care payors.
  • Bachelor’s Degree (Minimum)
  • Knowledge of HIPAA billing requirements to include claims (UB & 1500 current versions), & basic CPT coding, ICD 9/ICD10.
  • Ability to read & apply complex contractual arrangements to identify expected reimbursement to include fee schedules, per diems, high dollar stop loss, DRGs, APCs, & carve outs.
  • Must understand payor-specific requirements & utilize pay-or websites, procedural billing manuals, & standard operating procedures.

Job Description:

Under the direction of Revenue Cycle Leadership, this position is responsible for the billing & collections of outstanding account balances for commercial, government, & managed-care payors, as assigned. The Special Accounts Coordinator is required to identify payor trends & issues, analyze the impact to the organization & take appropriate action. It is a requirement for the Special Accounts Coordinator to read, interpret & apply complex payor contract language to expected reimbursement calculations & pursue all payments due to the organization. The Special Accounts Coordinator must perform account collection activities utilizing internet resources & professional telephone communication etiquette. The Special Accounts Coordinator is required to compose professional written correspondence with all internal & external entities. Must demonstrate organizational & time management skills to manage account collections. Serves as a resource to the Reimbursement Specialists in identifying payor issues & trends. Assists with training of staff. Works with clinical department on revenue cycle issues including charges, E&M coding, authorizations, late charges, & other issues impacting the revenue cycle. Resolve all claim edits, stop bills, & account edits including late charges, charge errors, consecutive accounts, duplicate accounts, & claim errors, in order to submit timely & accurate claims to government agencies, commercial payors & other payors, as assigned, in accordance with federal, state, industry regulations & standards.  Must review all denials & take corrective action based upon national denial reason codes, remark codes & payor specific codes. Must determine appropriate appeals or adjustments based upon analysis of the denial codes, charges, revenue codes, CPT codes, HCPCS codes, & ICD-9 (10) diagnosis/procedure codes. Identifies all over payments & refunds within the guidelines of federal & state regulations, payor requirements, & hospital standard procedures. Receives & processes requests from patient families, insurance carriers, government entities, & other sources. Must provide appropriate requested information to ensure quality customer service & appropriate adjudication of claims. Compliant with Federal, state, & hospital regulations to ensure privacy is maintained in compliance with HIPAA.  Identifies underpayments & other payer issues & pursues payment through contact with payor either by telephone, email, or formal written communication. Runs reports to analyze impact of payor denials/underpayments on the revenue cycle.  Prioritizes work appropriately to ensure all accounts are being submitted & followed up in a timely manner to include credit balances, high dollar accounts, & aging accounts. Meets department quality & productivity standards.  Assists leadership with training of new staff & with training staff on new processes & payor issue resolution. Works with clinical departments to assist with resolution of issues affecting revenue cycle to include charge errors, late charges, claim errors & invoice processing.

Pay:$20/hr

Schedule: Mon.-Fri.; 8:00 a.m. – 4:30 p.m./flexible. 

Thank you for your interest, Sedona Staffing.