Billing and insurance coordinator job description

Job DescriptionWorking closely with and reporting to the Operations Manager this position is responsible for overseeing all aspects of insurance related issues across MGH Urology while providing functional guidance to Patient Service Coordinators (Urology Care Team Coordinators). Insurance-related processes include but are not limited to prior authorization management for clinic-based procedures, Urology-ordered radiology tests and NWH-based OR cases, denial management, and development of billing-related processes and training of support staff. The Prior-Authorization/Billing Coordinator serves as the primary contactbetween MGH Urology and the PBO (Professional Billing Office) for all aspects relating to billing.

In collaboration with the Operations Manager will support the development of and operationalization of processes related to the obtainment of prior authorizations for clinic-based procedures, NWH-based OR cases, prescriptions, radiology studies and other common prior auth needs for MGH Urology

As a critical thinker will make recommendations to enhance existing processes as well as help to develop and implement new processes to protect and increase reimbursement.
Assists with the communication of policy and procedure changes to staff Proactively identifies sources of issues and communicates these to the appropriate parties. Provides staff updates on new initiatives in partnership with the PBO to improve billing performance and collections while reducing denials Establishes and maintains collaborative relationships with Faculty, APPs, and internal staff and major payors Under the direction of the Operations Manager, updates forms, prior authorization materials and processes to be used by the department Implements and maintains payer-specific electronic portals to support efficient and effective completion of prior authorizations and certifications In partnership with the PBO Billing Manager, assists with reviewing statistical reports including but not limited to: missing referrals open encounters number of outstanding provider applications monthly write-offs payer rejections Understands financial services and self-pay resources and provides patients with relevant information Understands HMO, Managed Care and other third-party insurers. Functions as a resource for patients and staff around managed care plans, insurance and referral/prior authorization issues and possesses the ability to perform electronic insurance verification In partnership with the MGPO Professional Billing Office (PBO), maintains a list of MGH-accepted insurance plans and master charge lists and cost estimates for patient visits Serves as a resource to Urology Care Team Coordinators for all prior authorization-related questions. Provides process training as necessary Monitors Epic encounter completion and ensures encounter closing with providers to ensure timely completion of notes and billing In conjunction with respective Care Team Coordinators, reviews upcoming clinic schedules to ensure all scheduled patients have appropriate insurance coverage, authorizations and referrals in place. Creates financial waivers and manages the collection of fees from self-pay patients ahead of their visit Works closely with Department leadership and the MGPO PBO to ensure all providers (MDs and APPs) are properly enrolled with payers Answers Hospital and MGPO billing questions regarding encounters Maintains and manages reports from MGPO and hospital denials and claims that require further review, documentation and resubmission. Works with patients to resolve billing problems Provides excellent customer service to patients, staff and insurers Performs all other duties as assigned including all aspects of the Patient Services Coordinator


Qualifications

Ability to successfully manage numerous tasks simultaneously Effective communication and analytical skills. Ability to provide support, direction, and development of staff. Ability to conduct training sessions Ability to make decisions quickly and independently. Ability to provide guidance in a work environment. Knowledge of computer-based software programs such as Excel, MS office, and MS Word, EPIC High School diploma required, Bachelor's Degree preferred


EEO Statement
Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged. Partner's Healthcare is acting as an Employment Agency in relation to this vacancy.

Berger Transfer & Storage, Inc is a leading provider of relocation, distribution, and warehousing services. Founded in 1910, Berger has been providing moving and storage services to individuals and businesses for over 100 years! Berger is Allied Van Lines' largest agent with 16 locations throughout the U.S

Berger Transfer & Storage, Inc is growing and that means new career opportunities! Join us and be part of an iconic family of companies with a great culture, unmatched co-worker camaraderie and plenty of development opportunities! At Berger, our top priority is having employees who can live up to the demanding expectations of our customers and markets. We believe our employees, who bring their hard work and dedication each and every day, are the source of our strength and success. Our ideal candidate will have an immediate connection to Berger's Mission Statement of helping every customer to have a positive, memorable experience, as well as embodying our vision and values. Candidates who connect through positive and respectful interactions, and strive to be open, honest and fair will be at the top of our list.
We are seeking a BILLING COORDINATOR to join our team in Roseville, Minnesota. Our Billing Coordinator will specialize in working with our Distribution and Household Move teams to process billing using the Berger and Allied System. The Billing Department is our internal team that is responsible for efficiently and accurately invoicing and processing distribution of revenue to the Berger branches and Allied.

Responsibilities for our Billing Coordinator include but are not limited to:


Actively billing the Distribution and Household moves using Berger and Allied's system(s); Ensuring payment of long haul drivers and local contractors; Accurately distribute revenue to Berger's 16 branches and to Allied; Work within the work-flow system to manage assigned orders; Interlining of vendor invoices; Perform other projects and initiatives, as required.


The successful candidate for this position will share the following knowledge, skills and abilities:


High School Diploma or Equivalent is preferred; Secondary Education is preferred; Minimum of 2 years office experience is preferred; Ability to work some evening and/or weekend hours during peak season; Knowledge of moving industry tariffs would be preferred and helpful to his opportunity; Must be able to demonstrate previous successful experience experience performing the following key skills:
Knowledge and ability to use typical office equipment (PC, calculator, fax machine, etc.); Strong customer service and interpersonal skills; Good oral and written communication skills; Strong attention to detail; Ability to multitask in a fast-paced environment; Basic math skills including addition, subtraction, multiplication, division, percentages and fractions


Along with the opportunity to be an agent of change and make your own mark at a great company with a unique culture, we can we offer you:


Competitive Pay; Medical, Dental & Vision Benefits; 401K; Paid Time Off (Begin accruing your very first day of employment!); Employee Discounts with Verizon, Sketchers and more!


Berger Transfer & Storage, Inc is an Affirmative Action/Equal Opportunity employer that welcomes diversity in the workplace. All applicants will receive consideration for employment regardless of their race, color, creed, religion, national origin, sex, sexual orientation, disability, age, marital status or status with regard to public assistance.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Grand View Health, which includes Bucks County's first hospital, has provided residents of Bucks and Montgomery counties with comprehensive health-care services since 1913. Now a century strong, Grand View offers a range of inpatient and outpatient care-particularly emphasizing the areas of surgery and orthopedics, women's and children's health, heart and vascular care, and cancer treatment. Our colleagues enjoy the best of both worlds by working for a high-quality, low-cost health-care provider in a collaborative, community environment. Help us build this new era of wellness and lead our community to a healthier future.
Responsibilities

Under the direction of the Billing Office Manager, the Billing Coordinator is responsible for supporting the professional billing process in Grand View Medical Practices. This includes closely monitoring all outstanding accounts receiveable to ensure the timely and accurate processing of all claims for services rendered to our patients.

Essential Functions:

* Possesses a thorough understanding of managed care contracts and their limitations.
* Acts as liaison between all insurance company representatives. Stays informed of third party regulations and requirements by reading all newsletters and periodicals published by different insurance companies.
* Maintains working knowledge of CPT and ICD10 codes.
* Responsible for the collection process which includes evaluating and reporting delinquent accounts directly to the collection agency as well as calling patient for overdue balances and sending collection letters.
* Makes deposits of all processed checks for the day. Responsible for checking to see if deposits from all the GVMP offices equal at the end of the month.
* Prints patient statements and submitting patient claims electronically or on paper as indicated.
* Locates EOB's and receipts as well as medical charts.
* Keeps track of problems and resolve issues.
* Processes refunds and credits for patients and insurances.
* Processes capitation checks and reports.
* Maintains a full understanding of the different insurances and how they are billed.
* Understands and submits claims via web to MA.

Schedule: Monday to Friday, 8:00am - 4:30pm

Qualifications

Education and Experience:Bachelor's Degree preferred Over 3 years to 5 years Office experience, including 1 year in a health care organization preferred Skills and Abilities:- Possesses familiarity with Microsoft Office (Word, Excel, PowerPoint, etc.),- Service-oriented,- Demonstrated time management and priority setting skills,- Excellent organizational skills,- Demonstrated analytical skills,- Demonstrated problem solving skills,- Demonstrated written communication skills,- Strong verbal communication and listening skills,- Effective interpersonal skills,- Competency in the use of a variety of computer hardware and software systems,

Responsibilities Monday to Friday, 8:00am - 4:30pm