Account Resolution Coordinator

Children's Healthcare of Atlanta; Atlanta (GA); On-site; USD 42,000 - 52,000; Full time

Job summary

Children's Healthcare of Atlanta Inc. is seeking an experienced insurance billing/collections specialist to meet department targets and resolve denial issues.

You will work closely with the patient accounts team to bill, follow up, and collect from third-party payors, while maintaining accurate documentation and policy compliance. The role requires knowledge of UB04/HCFA 1500, excellent phone and written communication, and the ability to meet performance goals.

Qualifications

• Knowledge of third-party requirements and policies including Medicaid, Managed Care, BCBS, and other payors.
• 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 meet department/individual goals.
• Must type 45 words per minute (WPM).
• Must operate personal computer-based systems including word processing, spreadsheets and billing software.

Responsibilities

• Performs daily billing of claims to third-party insurance following UB04 and HCFA 1500 guidelines.
• Ensures special billing needs by payor are performed to prevent denials and delays.
• Prepares and submits all final bill claims, secondary claims, rebills, and late charges daily.
• Performs routine follow-up on unpaid insurance claims and resolves problems causing delays in reimbursement.
• Documents all communications with third-party payors and guarantors via online activity codes.
• Prioritizes accounts in the assigned queue to ensure timely submissions.
• Complies with department workflows and routines.
• Contacts guarantors for needed information to resolve delays in reimbursement.
• Works correspondences daily to add Medicaid eligibility to self-pay and commercial accounts.
• Handles returned mail on high-dollar accounts and third-party payor communications.
• Take action to resolve all insurance, bad debt, and self-pay unpaid balances.

Skills

Medical terminology

Telephone skills

Written communication

Typing 45 WPM

Billing software

UB04 HCFA

Payor knowledge

Education

High school diploma or equivalent

Tools

Epic Resolute

Dentrix Dental

Clearinghouse

Job description

Work Shift

Day

Work Day(s)

Friday, Monday, Thursday, Tuesday, Wednesday

Shift Start Time

8:00 AM

Shift End Time

4:30 PM

Worker Sub-Type

Regular

Children's is one of the nation's leading children's hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We're committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children's.

Job Description

Meets all department collection and follow-up performance expectations. Completes assigned work in a timely fashion and reports any issues or obstacles to lead collector or patient accounts supervisor to ensure swift resolution. Identifies payor trends proactively in relation to zero payment, payment variance, billing, and denials. Works closely with other collectors and lead collectors in completing claims billing and follow-up collection activities. Completes projects as requested by patient accounts manager or patient accounts supervisor. Adheres to company and department attendance, basic work requirements, and other policies and procedures.

Experience

• One year of experience in insurance billing or collections, with a general knowledge of hospital business office functions

Preferred Qualifications

• Some college
• Two 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

Education

• High school diploma or equivalent

Certification Summary

• No professional certifications required

Knowledge, Skills and Abilities

• 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

Job Responsibilities

1. Performs daily billing of claims to third-party insurance following the guidelines of the UB04 and HCFA 1500 manual.
2. Ensures that special billing needs by payor are performed to prevent denial of claims and delay in payment.
3. Prepares and submits all final bill claims, secondary claims, rebills, and late charges on a daily basis, maintaining a current status.
4. Performs routine follow-up on unpaid insurance claims, taking appropriate action to resolve problems causing delay in reimbursement.
5. Documents all telephone and correspondent communications with third-party payors and guarantors thoroughly via online activity codes.
6. Prioritizes and works proactively on accounts in assigned work queue to ensure all accounts are submitted in a timely manner.
7. Complies with department workflows and routines.
8. Contacts guarantors and other insured parties when additional information is needed, and takes appropriate action to resolve any delay in reimbursement.
9. Works correspondence daily, including adding Medicaid eligibility to self-pay and commercial accounts.
10. Works returned mail on high-dollar accounts and correspondences from third-party payors.
11. Takes appropriate action to resolve all insurance, bad debt, and/or self-pay unpaid balances.

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.

Primary Location Address

1575 Northeast Expy NE

Job Family

Patient Financial Services