Billing Coordinator Job at APS Health Care PR, Puerto Rico

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  • APS Health Care PR
  • Puerto Rico

Job Description

Job Description

Job Description

Position Summary:

The Billing Coordinator will follow up on unpaid claims utilizing monthly aging reports, filing appeals when appropriate to obtain maximum reimbursement. Process and monitor incoming payments and secure revenue by verifying and posting receipts in compliance with financial policies and procedures.

Essential Functions:

  1. Collect, post, and manage patient account payments.
  2. Submit claims, investigate rejected claims to see why denial was issued.
  3. Submit appeals and reconsiderations to insurance.
  4. Review delinquent accounts and call for collection purposes.
  5. Escalate problem accounts to Manager to obtain payment.
  6. Process payments from insurance companies.
  7. Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
  8. Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding.
  9. Reports possible instances of fraud and abuse, if found.
  10. Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable.
  11. Provide training in billing practices.
  12. In addition, all other duties assigned by the manager and/or supervisor.

Education:

  • Certified High School Diploma or equivalent.

Experience:

  • Minimum 3 years experience in medical billing with billing or medical coding certification.
  • Knowledge of insurance guidelines.
  • Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement

Knowledge:

  • Personal computer experience should include working with Microsoft Word, Excel, Power Point and Outlook at the intermediate level at a minimum.
  • Experience in CPT and ICD-10 coding; familiarity with medical terminology.
  • Know several different coding systems, including Level 1 HCPCS and Level 2 HCPCS.

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