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Healthcare Billing Coordinator

3 months ago

Collingwood, Ontario, Canada ZOLL Medical Corporation Full time

Overview:

Healthcare Billing Coordinator

This role involves the meticulous validation and entry of patient and insurance data into specialized billing systems. The successful candidate will possess a strong understanding of billing protocols, insurance regulations, and will be adept at addressing inquiries from both patients and insurance providers. Confidentiality of patient information is paramount, and accurate data entry is essential.

Key Responsibilities:

  1. Ensure the accuracy and completeness of patient demographic details.
  2. Utilize hospital systems or authorized vendors to verify and obtain patient demographic information.
  3. Validate essential documents such as Assignment of Benefits (AOB), consents, and Certificates of Medical Necessity (CMN).
  4. Confirm consistency of patient names across all documentation.
  5. Ensure alignment of service dates, mileage, and locations in software with clinical records.
  6. Verify insurance eligibility and adhere to coordination of benefits protocols.
  7. Research new payer information and follow established procedures for new payer requests.
  8. Request missing patient information from healthcare facilities or directly from patients or their legal representatives.
  9. Initiate retro-authorization requests and follow up with payers.
  10. Upload relevant documents into the patient’s electronic chart.
  11. Comply with federal and state billing regulations.
  12. Input demographic data into billing software and/or payer portals.
  13. Initiate both paper and electronic claims submissions to payers.
  14. Document all actions taken in clinical and billing systems.
  15. Resolve issues related to electronic claim rejections.
  16. Follow fair debt collection practices when communicating with patients regarding overdue accounts.
  17. Review self-pay accounts to assess the completeness of collection efforts.
  18. Address payer-specific validations in billing software prior to claim submission.
  19. Process returned mail by validating new demographic information and restarting the patient statement cycle.
  20. Perform additional responsibilities as assigned.

Qualifications:

  1. Preferred experience of one year in the medical billing sector, though not mandatory.
  2. Ability to communicate confidently with insurance representatives and patients.
  3. Familiarity with billing forms such as 1500 and UB04.
  4. Understanding of behaviors associated with contracted and non-contracted payers.
  5. Capacity to thrive in a dynamic work environment and adjust tasks based on management direction.
  6. Knowledge of medical terminology.
  7. Ability to work autonomously.
  8. Strong analytical skills to make informed decisions.
  9. Professional appearance and demeanor.
  10. Ability to interact with all levels of staff in a professional manner.
  11. Capability to analyze issues and provide management with feedback on strategies for effective solutions.
  12. Proactive approach to learning company policies and procedures.
  13. Adherence to HIPAA confidentiality and privacy compliance, as well as company ethics and policies.
  14. Experience with Microsoft Office and PDF editing tools.
  15. High School diploma or GED equivalent required.
  16. Typing speed of 45 wpm and proficiency in 10-key by touch.
  17. Ability to operate standard office equipment.

ZOLL Medical Corporation values diversity and is an equal opportunity employer. We do not discriminate in hiring or employment based on race, color, religion, national origin, citizenship, gender, gender identity, genetic information, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by law.