Billing Coordinator I - Sarasota Memorial Health Care System

Job Summary:

Reviews and processes billing both electronic and manual claims as well as keeping updated with the ever-changing insurance demands and reviewing rebill requests. Identifies and problem solves billing inaccuracies while keeping statistics of errors found and updating info in AM/PFM as needed. Ensures all claims are submitted both accurately and timely. Manually prepares all special handling claims as well as bill secondary insurance and print/request necessary attachments such as medical records and itemized. Calculates and posts allowances for Medicaid accounts and maternity package plans as well as adjusts off non-covered charges and others outlined by the individual insurance carriers. Verifies insurance eligibility for Medicaid and their HMO's while also searching for authorizations and specific provider numbers. Maintains knowledge and use of the SSI billing system as well as other related programs such as AM/PFM, AccessANYware, EQ Health, FEMMIS and Passport. Documents billing information and works closely with other related departments to ensure 'clean' claim submission.
Responsible for keeping abreast of and complying with all managed care contracts and third party billing regulations. Clears fatal edits on AM/PFM accounts to ensure “clean” claim submission to increase the number of daily claims worked by each biller and increasing revenue reimbursement. Receives and responds to incoming calls and representative requests in a professional and timely fashion promoting customer satisfaction. Works as a team member demonstrating time management skills and communicating new information or changes.

Required Qualifications:

- Require a minimum of three (3) years of experience with PC-related software with strong analytical computer skills. A Bachelor’s degree can substitute for the required experience.

Preferred Qualifications:

- Prefer experience in processing health insurance claims.
- Prefer demonstrated ability to cross train within the department.
- Prefer working knowledge of ICD-10 and CPT coding.
- Require the ability to type minimum of thirty (45) words per minute.
- Prefer Certified Patient Account Technician (CPAT) or Certified Revenue Cycle Specialist (CRCS).
- Prefer the ability to use a 10 key adding machine both quickly and accurately.
- Prefer the ability to communicate effectively with patients and the public demonstrating a high level of professionalism.
- Prefer demonstrated interpersonal skills including the ability to handle difficult situations diplomatically.
- Prefer demonstrated computer literacy with windows based programs.
- Prefer demonstrated effective oral and written communication skills.

Mandatory Education:

HS EQ: High School Diploma, GED or Certificate

Work Days/Shift/Start Time:

Full time, Mon-Fri, start times vary from 7am to 9am