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Billing Coordinator - Horizon Healthcare Services


Company

Horizon Healthcare

Cost Center

3310 Horizon Health Services Operations

Supervisory Organization

Patient Account Services

Grade

Summary

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This position is full-time, 40 hrs/week, Monday-Friday 8:30am-5:00pm. Every 10th weekend with prior Monday off.

POSITION SUMMARY:

In conjunction with Office Manager, coordinates, leads and oversees the provision of medical billing and collections services to support the Horizon Healthcare Services operation.  Serves as a back-up to the Office Manager in his/her absence or unavailability.

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties

Oversight of Daily Department Operations

  • Displays effective leadership of department by organizing and coordinating staff and resources to maximize efficiency & quality outcomes.
  • In conjunction with Manager, defines responsibilities & goals for employees.  Orients & trains employees in an understandable & complete manner.
  • Ensures timely, accurate & cost-effective billing and collections function.
  • Monitors and ensures compliance with all governmental regulations & applicable internal policies.  Ensures departmental compliance with HIPAA regulations.
  • Exhibits good judgment and initiative when faced with problems, issues or assignments for which clear instruction may not be provided.
  • Consistently follows-up on customer service concerns with supervisor so that process improvements may be implemented
  • Serves as back-up to the Office Manager, remaining fully cross-trained in all duties relating to the billing & collections function
  • Routinely reviews uncompleted job tasks and assists employees with prioritizing workload, displaying a proper sense of urgency & importance.

Referral Processing

  • Analyzes patients' insurers utilizing the best financial scenario to obtain patient satisfaction, abide by law, and satisfy the HHS mission.
  • Generates accurate & timely price quotes for new patients and/or new therapies.
  • Verifies that all required referral information has been received & is complete. Communicates via fax/e-mail to the appropriate persons that it has been finalized.
  • At the time of receiving referral, generates complete & accurate Medicare CMN's or other applicable documents needed for claim submission.
  • Analyzes authorizations for content and dates and understands the responsibility of the nursing agency.
  • Is proactive in problem-solving incomplete information to eliminate errors later in billing and/or collections process.

Infusion Billing

  • Ensures that deliveries/returns are properly entered into inventory and billed correctly to customers.
  • Generates & oversees the accurate and complete claims processing for payors, adhering to contract requirements and governmental regulations.
  • Ensures that claims are generated using proper infusion billing technique (i.e., per diem, discount, cost +, etc.)
  • Thoroughly reviews all claims for accuracy & completeness prior to mailing/distribution.
  • Reviews account adjustments ensuring proper patient, month and therapy.

Collections

  • Ensures that follow-up calls and collection calls are made within established timeframes using appropriate techniques and professionalism.
  • Ensures that monthly patient statements, dunning letters and collection agency information is prepared timely and accurately.
  • Reviews accounts receivable from HHS aging report and communicates all unusual circumstances to supervisor.
  • Follows guidelines mandated by federal and state insurers when representing claims for appeal.

Reporting & Computer System Management

  • Ensures referral information entered into HAI is complete & accurate.  Serves as a double-check to Clinical Coordinator.
  • Thoroughly enters patient insurance information, including authorizations, recording dates for follow-up and continuation of case management patients.
  • Demonstrates understanding of weekly RN Visit Report, completes accurate data entry and reports unusual findings to manager
  • Accurately posts cash, adjustments & transfers to specific patient and/or date of service.
  • Demonstrates thorough understanding of contract maintenance & payor coverage profile in HAI and uses it appropriately, as needed.
  • Prepares monthly Billing Accuracy Log and submits to Office Manager & COO for approval by established deadline.
  • Completes accurate month-end data entry by established deadline.  Prepares ad hoc reports as requested.
  • Demonstrates proficiency in use of HAI system, spreadsheet & word processing applications, using them effectively as a tool and sharing knowledge with others.

SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:

  • Remains fully cross-trained with all department members, understanding all aspects of the dept with 100% commitment to teamwork.
  • Other duties as assigned.

JOB REQUIREMENTS

MINIMUM REQUIRED QUALIFICATIONS:

  • High school diploma or equivalent.
  • Minimum two (2) years’ prior medical billing and general office experience.
  • Minimum two (2) year’s data entry/computer experience.  Minimum 50 wpm typing speed and excellent 10-key skills.

PREFERRED QUALIFICATIONS:

  • Minimum two (2) years prior medical billing experience in the home infusion field.
  • Minimum two (2) years’ experience in accounts receivable and collections, preferably in the medical field.
  • Two (2) years prior supervisory experience.

COGNITIVE REQUIREMENTS:

Attention/Concentration:

The position requires strong concentration skills.  The individual must have the ability to voluntarily sustain concentration to a task over an extended period of time as a result of an effortful and usually deliberate heightened and focused state of attention.

New Learning and Memory:

The position requires that an individual be able to learn new tasks quickly and effectively.  Job requirements change frequently.  The ability to understand and carry out detailed, involved instructions is mandatory.

Problem Solving, Reasoning and Creative Thinking:

The position deals with issues or problems that often require thoughtful reasoning before arriving at approaches or solutions.  Some independent thought, planning or origination of options and solutions is necessary.  The individual must have the ability to apply principles of reasoning and problem solving to resolve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

APTITUDES:  The following are essential requirements of the position in relation to job-worker situations.  These items describe how a worker must adapt, adjust, conform or act:

Repetitive work: Ability to continuously perform the same type of work for extended periods of time, according to set procedures, sequence or pace.

Performing under stressful conditions: Ability to perform under stress when confronted with emergency, critical, unusual, or dangerous situations, or in situations in which working speed and sustained attention are critical aspects of the job; to be subject to danger or risk, or to tension as a regular, consistent part of the job.

Variety and change: Ability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure involving significant differences in technologies, techniques, procedures, environmental factors, physical demands, or work situations.

Communication:  Ability to exchange information with others clearly and concisely; to present ideas, facts and technical information.

Interpersonal relations: Ability to maintain relationships that facilitate task accomplishment; to cooperate and resolve conflicts; to recognize needs and be sensitive of others.

Repetitive work: Ability to continuously perform the same type of work for extended periods of time, according to set procedures, sequence or pace.

EQUIPMENT USAGE REQUIREMENTS:

Equipment/Tools:   Network computer system and personal computer proficiency; 10-key adding machine; office copier, multi-line telephone system, FAX machine, postage meter, miscellaneous office equipment.

Software:   LG/Horizon Information System; Microsoft Office Products

PHYSICAL REQUIREMENTS

Rarely 0-10%; Occasionally 11-35%; Frequently 36-70%; Continuously 71-100%

Body Position/Movement:

  • Sit: Continuously
  • Stand: Occasionally
  • Walk: Occasionally
  • Bend: Occasionally
  • Push: Rarely
  • Pull: Rarely
  • Kneel/Squat: Rarely
  • Reach: Occasionally
  • Twist: Rarely
  • Balance: Occasionally
  • Climb: Rarely

Lifting: Degree of physical exertion is: Light, exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to move objects.

Sensory Abilities specifically required:

  • Vision
  • Hearing
  • Touch/Feeling

PHYSICAL ENVIRONMENT

WORKING CONDITIONS:  Exposure to hazardous elements or conditions is negligible.

Disclaimer: This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job.  It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards.  The percentages of time spent performing job duties are estimates, and should not be considered absolute.  The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole.  Incumbent must be able to perform all job functions safely.

Disclaimer

PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.

 

Search Firm Representatives please read carefully: PENN MEDICINE LANCASTER GENERAL HEALTH is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, all resumes submitted by search firms to any employee at PENN MEDICINE LANCASTER GENERAL HEALTH via-email, the Internet or directly to hiring managers at Penn Medicine Lancaster General Health in any form without a valid written search agreement in place for that position will be deemed the sole property of PENN MEDICINE LANCASTER GENERAL HEALTH, and no fee will be paid in the event the candidate is hired by PENN MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means.

BURLE Full Time Posted on 12/18/2020