Account Resolution Coordinator

10 Children's Healthcare of Atlanta, Inc.; United States; On-site; USD 42,000 - 64,000; Full time

Job summary

Children’s Healthcare of Atlanta is seeking a Billing/Collections Specialist to manage daily billing of claims and follow-up with payors to ensure timely reimbursement. The role requires knowledge of UB04 and HCFA 1500 guidelines, strong communication, and attention to detail.

The ideal candidate has 1 year of insurance billing/collections experience, familiarity with major payors, and proficiency with medical terminology and billing software.

Qualifications

• 1 year of experience in insurance billing or collections.
• Knowledge of third-party requirements and policies including Medicaid and BCBS.
• Must have excellent telephone communication and customer service skills.

Responsibilities

• Performs daily billing of claims to third-party insurance following UB04/HCFA 1500 guidelines.
• Prepares and submits final bills, secondary claims, rebills, and late charges daily.
• Performs routine follow-up on unpaid insurance claims to resolve delays in reimbursement.

Skills

Third-party knowledge

Phone communication

Written communication

Medical terminology

Goal oriented

Typing 45 wpm

Computer skills

Education

High school diploma

Some college

2 years experience in billing/collections

Tools

Epic Resolute

Dentrix Dental

Clearinghouse

Job description

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

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

Preferred Qualifications

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

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

• 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.

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

Children’s Healthcare of Atlanta has been 100 percent committed to kids for more than 100 years. A not-for-profit organization, Children’s is dedicated to making kids better today and healthier tomorrow. With 3 hospitals, 20 neighborhood locations and a total of 673 beds, Children’s is the largest healthcare provider for children in Georgia and one of the largest pediatric clinical care providers in the country. Children’s offers access to more than 60 pediatric specialties and programs and is ranked among the top children’s hospitals in the country by U.S. News & World Report. Children’s has been recognized as a Fortune 100 Best Place to Work, a Best Place for Working Mothers, and as a top employer for diversity and millennials.

We offer a comprehensive compensation and benefit package that supports our mission, vision and values. We are proud to offer an array of programs and services to our employees that have distinguished us as a best place to work in the country.

Connect to our mission of making kids better today and healthier tomorrow.