Ambulatory Coordinator

Midland Memorial Hospital; Midland (TX); On-site; USD 42,000 - 56,000; Full time

Job summary

Midland Memorial Hospital is seeking an Ambulatory Coordinator I to oversee the billing and collections of physician claims, filing submissions electronically or on paper, and ensuring accurate reimbursement. The role requires handling referrals, pre-authorization, verifications, and medical necessity issues in compliance with applicable laws and hospital policies.

Daily work is Monday through Friday, 8:00 AM to 5:00 PM, and responsibilities include timely follow up on claims, resolving payer

Qualifications

• High School Graduate or Equivalent
• Two (2) years billing or coding experience preferred

Responsibilities

• Resolution of all billing claims; electronic and manual. End of month reporting and distribution of reports to contracted physicians.
• Handle referral/authorization issues, pre-authorization requirements, verifications, appeals, and medical necessity issues.
• Timely follow up of claims including completion of additional tasks to ensure timely payment; respond to payer inquiries.
• Familiarity with ICD-9/10, CPT codes, modifiers and 1500 form locators.

Skills

Billing experience

Coding knowledge

Attention to detail

Communication

Education

High School Graduate or Equivalent

Job description

Job Description

Responsible for the billing and collections of physician claims. This position will file physician claims for reimbursement, including electronic and paper submissions. Monitor physician systems, billing and patient accounting system, department reports, taking corrective action to ensure accuracy in claim filing to payers. The Ambulatory Coordinator I will function in accordance with federal, state, and local laws; rules and regulations; and policies, procedures and guidelines of the employing health care institution or practice setting. This position is also responsible for consistent commercial insurance follow-up of physician claim(s) greater than 30 days, aged from final bill date, and resolution of same in a timely and cost-effective manner. This requires forming relationships with the individual insurance payers/clients in order to have the maximum response for timely and accurate payment. Monitor patient accounts assigned for accurate payment(s) or non-payment and take compliant actions for account reimbursement.

Shift and Schedule

Monday - Friday: 8:00 AM - 5:00 PM

Essential Functions/Performance Expectations

• Resolution of all billing claims; electronic and manual. End of month reporting and distribution of reports to contracted physicians.
• Able to understand, explain and handle referral/authorization issues, pre-authorization requirements, verifications, appeals, and medical necessity issues.
• Timely follow up of claims including the completion of additional tasks to assure claims are paid timely. Ability to respond timely to insurance and billing inquiries made in person, by mail or over the phone. Completion of all billing edits
• Awareness, knowledge and cognitive ability in use of 1500 form locators, ICD 9 codes, CPT codes, and modifiers

Education And Experience

• High School Graduate or Equivalent
• Two (2) years billing or coding experience preferred

Physical Requirements

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual must be able to:

• Stand, walk, sit, stoop, reach, lift, see, speak and hear. Lifting is limited to 35 lbs. for clinical staff and to 50 lbs. for non-clinical staff. The individual must use an assisted-lift device or get another individual(s) to assist with the lift that is over these maximum limits.