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Aug 23, 2021
Mon, Tue, Wed, Thur, Fri
For the department of Otolaryngology, Maxillofacial Dental team, the Pro-Fee Coordinator will be responsible for assisting in maintaining and monitoring the day to day billing and processing of billing and collections activities within the business unit. Responsible as a team lead in assisting in reviewing and analyzing the accuracy of staff work. Will assist in weekly and monthly report preparation, developing office policies and procedures, serve as a lead for troubleshooting and problem solving and will be expected to exercise independent judgment. Maintain strict confidentiality of patient and staff information. Promote team work and assist in identifying areas of improvement and recommend coordinated actions to bring about changes. Specific duties and responsibilities: Procedural Knowledge: • Responsible for maintaining and monitoring the day to day processing of assigned billing functions within the Unit. • Responsible for the collection of unpaid third-party claims and appeals, using various applications of JHM and JHU/ PBS billing applications. • Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal. • Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract. • Applies appropriate discounts / courtesies based on department policy. • Prepares delinquent accounts for transfer to self-pay collection unit according to the follow-up matrix. • Prints and mails claim forms and statements according to the follow-up matrix. • Retrieves supporting documents (medical reports, authorizations, etc) as needed and submits to third party payers. • Appeals reflected claims and claims with low reimbursement. • Monitor invoice activity until problem is resolved. • Process daily mail, edits reports, file or pull EOB batches. • Responsible for reviewing and analyzing the accuracy of staff work. • Responsible for overseeing the business unit in the absence of the management. • Assist in training new staff and existing staff members. • Provide feedback regarding problems to management and assists in problem resolution. • Generate weekly and monthly productivity reports as assigned. • Communicate with appropriate individuals outside the assigned department or institution as designated by management. • Assists management in assigning and tracking a portion of the daily work. • Serves as back-up for report generation in Manager’s absence. • Serve as a resource for staff questions and provides staff training as needed. • Identifies and resolve key issues and takes appropriate action to respond to complex patient and medical insurance inquiries. Technical Knowledge: • Comprehensive knowledge and compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI). • Working knowledge of JHU/ PBS Billing Applications. • Utilize online resources to facilitate efficient claims processing. • Uses relevant functions of (IDX) and (EPIC) billing systems. Professional and Personal Development: • Participate in on-going educational activities. • Assist in the training of staff. • Keep current of industry changes by reading assigned material on work related topics. • Complete three days of training annually. Department Specific Responsibilities: • Will work with the Maxillofacial Dental team to provide expert medical billing activities. Will also work with Otolaryngology billing team on an as needed basis. Service Excellence: • Must adhere to Service Excellence Standards. o Customer Relations o Self-Management o Teamwork o Communications o Ownership/Accountability o Continuous Performance Improvement Minimum qualifications (mandatory): • HS/GED required. Associate’s degree or higher level degree preferred. • Two years’ experience medical billing experience in a similar environment is required. • Additional education may substitute for required experience, to the extent permitted by the JHU equivalency formula. Additional Knowledge, Abilities and Skills: • Able to operate basic office equipment, e.g. photo copier, fax machine, scanner, PC, telephone, etc. • Strong organizational and analytical skills. • Excellent organizational skills. • Aptitude for figures and attention to detail. • Ability to interact effectively. • Capable of meeting deadlines and working well under pressure. • Knowledge of PCs and PC applications. • Excellent interpersonal, communication and customer service skills required. • Knowledge of JHM and JHU/ PBS billing applications.