Patient Management Coordinator jobs in Fort Lauderdale, FL

JOB SUMMARY:

The Billing Coordinator is responsible for the accurate and timely claims submission, collections, and reconciliation for all reimbursement.

QUALIFICATIONS:

• Graduation from an accredited high school or attainment of a GED certificate from an accredited institution.
• Experience with CPR system.
• Knowledge of Medicare and other regulatory billing codes and practices to assess billing for accuracy prior to submission to appropriate agency or company for processing and payment. Should be well-versed in regulatory guidelines and industry standards for Medicare and/or specific payer benefit providers.
• Knowledge of Medicare and third-party codes and billing procedures as well as patient billing techniques.
• Healthcare billing and collections experience.
• Possess excellent medical and billing terminology skills; Ability to read, analyze and interpret prescription drug orders.
• Familiar with accepted billing/collection/reconciliation practices in a health care reimbursement setting.
• Detail-oriented with strong organizational skills.
• Ability to multi-task, prioritize, meet deadlines, and work independently.
• Knowledgeable and understanding in products and services provided by Patient Care America and program documentation requirements.
• Ability to anticipate the needs of the facilities and patients that we service.
• Possesses good interpersonal skills; ability to work independently and as part of a team.
• Facilitates work production results by incorporating exceptional planning and organizational skills.
• Utilizes clear verbal communication skills to source and exchange information; utilizes written communication skills to prepare documentation and report results as warranted by job responsibilities.
• Applies analytical skills to pre-established work processes that may require preparation of reports or documents for further review or analysis.
• Ability to identify problems within the work routine that can be handled at level and refer escalated matters for further resolution.
• Computer literacy in standard office applications.
• Promotes a philosophy that is customer driven with excellent service results.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Responsible for the timely submission of claims to Medicare, Medicaid and private third party insured and prescription drug payers; Corrects and resubmits front-end and back-end rejected claims.

• Ensures the accuracy, completion, timely submission, and maintenance of all documentation necessary for coverage, compliance, and reimbursement by routinely performing claims auditing and review processes. 
• Verifies that the services and products are correctly authorized, and that required documentation is on file.
• Responsible for the timely follow-up and collection of payments due to the organization. This is accomplished by generating invoices and/or following up with patients and/or payers.
• Uses extensive knowledge of pharmacy benefits, infusion coverage criteria, medical insurance billing and coding to bring resolution to account balances.
• Responsible for reviewing remittance data and reconciling payment amounts; Responsible for the review and reconciliation of all claims processed and assists the reimbursement department by resolving billing issues.
• Keeps the Director informed of system issues which impede the ability to transmit claims and works with teammates, both within and outside the department, to resolve such issues.
• Holds themselves accountable for meeting individual productivity goals set by the Director as well as team goals set by the department; Completes work in a timely manner.
• Communicates effectively with teammates within department; Supports the team culture within the organization by adhering to policies, practices, and the Company's mission statement.
• Performs job responsibilities within established regulatory guidelines (HIPAA /PHI) and reports non-compliant activity to the Director.
• Protects patient and company confidentiality in all matters of processing accounts.
• Provides exceptional customer service to patients, internal and external customers, all contacts, and third-party payors; interacts in a professional manner with all teammates in order to promote a cohesive working environment.
• Looks for ways to improve and promote quality processes within and outside of the department.
• Adapts to and demonstrates multi-tasking skills when dealing with frequent changes in an ever-evolving work environment.
• Recognizes the need for change and the results of improved work processes.
• In cases where electronic transmission is not available, the Reimbursement Specialist assures that a paper claim is properly completed and submitted in a timely manner.
• Evaluates payments are received in accordance with the fee schedule.
• Works with the intake and reimbursement department to manage the entire reimbursement
• process from insurance verification through final collection.
• Manages the refund process for any overpayment and/or duplicate payments for the same service.
• Ensures that invoices are submitted for services and products that are properly ordered and confirmed as provided.
• Trains, educates, and supports staff on Medicare guidelines and updates, regulatory and compliance requirements, and accurate claims submission processes.

• Other duties as assigned by management.