BILLING COORDINATOR - Spherion

As the Client Engagement & Volunteer Coordinator, you?ll work closely with our Vice President of Community Engagement to create exciting programs and activities for clients and their families. You?ll also take the lead in recruiting, training, and supporting our amazing team of volunteers, helping to make a real difference in the community.

One of the highlights of the year is our summer camp, designed for kids and teens with inherited bleeding disorders. Camp typically runs in the summer, from Saturday to Friday, and may include the Fourth of July. It?s an all-hands-on-deck event, so all exempt employees join in the fun! Whether you?re helping out at camp, assisting with transportation, or just being there for the campers, you?ll get to be part of this memorable experience. Some travel and overnight stays may be required, and while we generally don?t approve PTO during camp week, we understand life happens and can review special requests if needed.

Responsibilities:

Responsible for following and tracking the claim from creation of an order,

through complete account reconciliation, taking the necessary steps to ensure payment.

Coordinate all insurance eligibility verifications for pharmacy clients.

Proactively obtain prior authorization for all prescribed products.

Ensure all systems have current and accurate insurance information listed.

File medical and/or pharmacy benefit claims daily for assigned accounts and serve as backup for other accounts as needed.

Follow up on filed claims to ensure they are adjudicated timely and according to payer contract.

Review EOBs and allocate payments received daily.

Research and resolve any payment discrepancies and ensure all assigned accounts are resolved timely and effectively in compliance with the payer

agreement.

Work with Payer Relations Account Manager to research denied and improperly processed claims and attempt to resolve any issue preventing or slowing

reimbursement.

Handle any remaining balance by filing claims to secondary insurers, co-pay assistance programs and creating patient statements or write-offs as needed.

Send Client Assistance Program (CAP) letters and enrollment forms to clients when appropriate.

Stay updated on billing requirements and changes for assigned payers.

Process correspondence and follow-up related to assigned accounts and provide backup duties for other accounts as needed.

Coordinate claim escalations and appeals to optimize collection opportunities.

In collaboration with Payer Relations Account Manager, research and respond to recoupments from Payers.

Gather documentation and generate refund letters to insurance companies and Medicare when needed, and work with finance to reconcile clients??? accounts.

Maintain all required documentation in specified timeframe in specified

timeframe.

Working hours: 9:00 AM - 5:00 PM

Skills:

Ability to learn new software programs

Proficient in Microsoft Office Suite applications

Be able to demonstrate high proficiency in Microsoft Excel

Ability to work independently on assigned tasks as well as to accept direction on

given assignments and work collaboratively with team members.

Strong time management skills with demonstrated ability to meet deadlines and

handle multiple priorities

Must be accurate and thorough-monitoring own work to check for errors.

Team player who brings initiative, positivity and creativity to the table

Ability to maintain confidentiality

Education:

No Degree Required

Experience:

1-4 years

Qualifications:

Medical patient account or revenue management certification preferred

At least 3 years??? experience billing and collecting on healthcare claims

Experience with eligibility verification and prior authorization processes

Apply Today

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Spherion, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact Callcenter@spherion.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc.In addition, Spherion offers a comprehensive benefits package, including health, and an incentive and recognition program (all benefits are based on eligibility).

key responsibilities

Responsible for following and tracking the claim from creation of an order,through complete account reconciliation, taking the necessary steps to ensure payment.Coordinate all insurance eligibility verifications for pharmacy clients.Proactively obtain prior authorization for all prescribed products.Ensure all systems have current and accurate insurance information listed.File medical and/or pharmacy benefit claims daily for assigned accounts and serve as backup for other accounts as needed.Follow up on filed claims to ensure they are adjudicated timely and according to payer contract.Review EOBs and allocate payments received daily.Research and resolve any payment discrepancies and ensure all assigned accounts are resolved timely and effectively in compliance with the payeragreement.Work with Payer Relations Account Manager to research denied and improperly processed claims and attempt to resolve any issue preventing or slowingreimbursement.Handle any remaining balance by filing claims to secondary insurers, co-pay assistance programs and creating patient statements or write-offs as needed.Send Client Assistance Program (CAP) letters and enrollment forms to clients when appropriate.Stay updated on billing requirements and changes for assigned payers.Process correspondence and follow-up related to assigned accounts and provide backup duties for other accounts as needed.Coordinate claim escalations and appeals to optimize collection opportunities.In collaboration with Payer Relations Account Manager, research and respond to recoupments from Payers.Gather documentation and generate refund letters to insurance companies and Medicare when needed, and work with finance to reconcile clients??? accounts.Maintain all required documentation in specified timeframe in specifiedtimeframe.

experience

1-4 years

skills

Ability to learn new software programsProficient in Microsoft Office Suite applicationsBe able to demonstrate high proficiency in Microsoft ExcelAbility to work independently on assigned tasks as well as to accept direction ongiven assignments and work collaboratively with team members.Strong time management skills with demonstrated ability to meet deadlines andhandle multiple prioritiesMust be accurate and thorough-monitoring own work to check for errors.Team player who brings initiative, positivity and creativity to the tableAbility to maintain confidentiality

qualifications

Medical patient account or revenue management certification preferredAt least 3 years??? experience billing and collecting on healthcare claimsExperience with eligibility verification and prior authorization processes

education

No Degree Required