Job description

Front Office Coordinator
Florida Surgical Clinic LLC is a rapidly growing multi-specialty practice specializing and priding itself in providing the best patient care for patients needing vascular and general surgery. The Front Office Coordinator is a crucial part of the clinic staff and has numerous duties and responsibilities to help ensure excellent patient care. We are looking for a professional multitasker who have the ability to provide the best customer care while answering phones, talking to a patient at the front desk, while coordinating a clinic and/or surgery schedule. A Front Office Coordinator, someone who can get HMO authorizations, or surgery scheduler who has experience with accurate and timely coding with current coding guidelines, regulations, and policies is preferred. This person will ensure the accuracy of ICD 10 diagnoses, CPT, HCPCS codes and other specified data utilizing the information from the medical record. Nextgen Meditouch experience is preferred otherwise EHR experience is necessary. This candidate must be a polite, outgoing person. He or she will represent the practice to the public by communicating with patients, insurance payers, industry representatives, internal/external clinical personnel, and internal/external physicians regarding scheduling and billing/coding. It is a full-time position working Monday, Wednesdays, Thursdays, and Friday in our Bradenton, FL office. Tuesdays will be at our Sun City Center office.

POSITION SUMMARY:

This employee will handle the scheduling, authorization requests, accounts receivable, billing, collections, assist with verification, run eligibility, coding and process all claims for our practice.

Billing/Coding/Scheduling Job responsibilities and expectations:

1. The coordinator is to code, abstract, analyze, and obtain accurate documentation for healthcare claims and payers including CMS.

2. The coordinator will follow the Official ICD-10 guidelines for Coding and Reporting and has a complete understanding of these guidelines to obtain accurate reimbursement for claims and assign diagnosis codes for insurance billing. The coordinator should have a complete understanding of CMS risk adjustment guidelines, understand the impact of ICD-10 coding, and follow the risk adjustment model including correction claims such as those that appear on Edit Reports.

3. He or she is responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT, HCPCS II, and ICD-10 materials, Federal Register, and other pertinent materials.

4. The coordinator will review claims data to ensure that assigned codes meet required legal, regulatory and insurance rules and that required signatures and authorizations are in place prior to submission. The coordinator will prepare and submit clean claims to various insurance companies either electronically or by paper with a goal standard of zero errors.

5. The coordinator ensures the coordination of invoice activities leading to timely reimbursement of receivables using available resources including databases, internet, and telephone sources. He or she researches and resolves denials received that have not passed payer edits and may lead to a final appeal of denied services. This requires knowledge of a variety of system applications both internal and external. He or she determines and initiates action to resolve rejected invoices, prepares payer corrections, and/or appeals using electronic and paper processes.

6. The coordinator will have an ability to interpret EOBs (explanation of benefits) and perform actions based on EOB. This includes answering questions from patients, clerical staff and insurance companies; successfully resolving denied claims; identifying and resolving patient and client billing complaints; and preparing and filing appeals when applicable.

7. The coordinator will also provide medical records when requested by payer/patients and obtain and update patient demographic information accurately.

8. The coordinator investigates payment status and determines ultimate patient financial responsibility. He or she collects outstanding balances and offers patient assistance with financial responsibility through various financial options.

9. The coordinator will identify over-payments. He or she will process refunds, adjustments, and appeals as necessary. The coordinator analyzes and resolves payment variances, which may involve preparation of adjusted and corrected bills, or adjusting accounts receivable entries in accordance with existing operating procedures. This may include the use of special reporting.

10. The coordinator will prepare information for the collection agency and report status of delinquent accounts. He or she will update the patient account record to identify actions taken on the account and work with patients and guarantors to secure payment on outstanding account balances.

11. The coordinator will participate in education activities and attends staff meetings and conduct his or herself in accordance with employee manual.

12. The coordinator maintains strictest confidentiality and adheres to all HIPAA, ARRA, local, state, and federal laws and regulations.

13. The coordinator will monitor insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner. He or she will identify coding or billing problems from EOBs and work to correct the errors in a timely fashion, assuring all claims are being paid accordingly. The coordinator will also assist in processing all PIP Claims with supporting documentation. He or she analyzes and clears payment variances and may prepare adjusted and corrected bills or adjust accounts receivable entries in accordance with existing operating procedures. In monitoring payer responses this may require use of Microsoft Office products and other software as necessary to ensure prompt payment.

14. The coordinator contacts providers, physicians, and/or patients to retrieve appropriate medical documentation to substantiate services provided and engage them in collecting from the payer.

15. The coordinator will evaluate patients’ financial status prior to visit from daily schedule. He or she will prepare, review, and send patient statements. He or she will utilize various resources to determine patient’s eligibility, benefits, and health plan confirmation including online payer databases, Nextgen Meditouch Eligibility platforms, and medical records that may result in provider or payer recoup/rejection activity.

16. He or she will sort, scan, and organize specified documents (EOBs, other related insurance) in patient charts and for the patient portal.

17. The coordinator will post to and manage account payments. The coordinator will post all insurance checks (including Direct Deposit payments) to correct patient accounts and document if patient owes co-pays. He or she will reconcile insurance payments with computer totals. This also includes calling insurance carriers if claims have not been paid in 60 days and monitoring insurance payments monthly.

18. He or she will provide payers with detailed itemization of services performed to ensure timely reimbursement. The coordinator prepares Ad Hoc financial reports for management to use in the evaluation of accounts receivable performance.

19. The coordinator should have an understanding of complex operative procedures, including endovascular procedures. He or she should be able to review an operative note and code complex operative procedures for surgical practices. He or she will coordinate and reconcile multiple surgical schedules to ensure complete charge capture. He or she will charge entry of multiple surgical cases into billing system in a timely manner. The coordinator performs other duties as requested or assigned.

20. Duties may change as the practice makes changes. The coordinator is expected to participate in special projects as needed. He or she will participate in teleconferences covering a wide range of topics that enables the practice to effectively collect account receivables. The coordinator will assist management with training of newly hired associates and re-education of collection teams as necessary. He or she monitors team results to ensure they are aligned with departmental goals and assures the completion and coordination of work in an associate’s absence, or as needed to maintain departmental standards.

21. The coordinator acts as an information resource for hard to collect accounts and a “grey area” subject expert, which ensures the coordination of special handling or reconciliation of spreadsheets for national payers.

22. The coordinator researches, resolves, and documents patient inbound and outbound calls involving a wide range of issues utilizing multiple information systems. This includes communications with internal business centers and external customers. He or she assures customer agreement by summarizing and closing each call appropriately.

23. The coordinator minimizes patient dissatisfaction by listening attentively, maintaining a professional tone, and acknowledging their concerns. Escalates patient issues and concerns to management.

24. The coordinator works with internal and external customers to obtain appropriate medical documentation, work orders, proof of delivery, or other documentation necessary to resolve open account issues.

25. The coordinator exercises good judgment, interprets data, and remains knowledgeable in details of all related Florida Surgical Clinic contracts, policies, and procedures. He or she participates in process improvement initiatives; and maintains teamwork, customer service production, and quality standards to assure timely, efficient, and accurate call resolution.

26. The coordinator sends patient necessary documentation required to complete the payment arrangement process. He or she prepares payment plan agreements or other correspondence including requests for secondary payers or Medicare/Medicaid verification or other documentation necessary to resolve open account issues. The coordinator ensures patients return documentation and signed payment agreements. He or she takes appropriate action when patient requests assistance in reconciling their financial responsibility, including proper follow up.

27. The coordinator will adhere and ensure compliance of OSHA, HIPAA, work place safety, State and Federal laws and regulations governing a medical practice. The coordinator maybe appointed as the office's compliance officer to ensure the practice stays compliant at all times with all laws, and governing agencies rules and regulations.

JOB QUALIFICATION SPECIFICATIONS:

Education Required:

High School Diploma, Associates degree in Medical Billing and Coding or Medical Coder/Biller Certification, (CMC, CPC, AAPC, NCCA, CCA, CCS, CBCS) is required. Other associate degrees or higher degrees will be considered.

Experience Required:

Professional coding experience with working knowledge of CMS risk adjustment model. Expert knowledge of medical terminology, abbreviations, disease, illness, and injury process. Managed care experience is a plus. Experience in customer service related to billing issues highly desirable. A minimum of two (2) years experience in insurance billing and CPT coding or any combination of education, training, or experience in a hospital business office. Experience with billing, computers, and business software programs including MS Office, data entry, preferably in a healthcare setting.

Skills Required:

- Experience in medical terminology, medical billing and collection practices are required.

- Must be able to effectively communicate verbally and in writing about complex coding issues.

- Ability to establish and manage working relationships with patients, clients, employees, insurance payers and the public.

- Ability to multi-task and work courteously and respectfully with all members of the healthcare community.

- Must be able to understand and follow verbal instructions and written policies/procedures to ensure adherence to standards and to instructions from management.

- Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.

- Responsible use of confidential information and maintenance of HIPAA and various other government agency compliance.

- Must be well organized and detail-oriented with the ability to work individually or as part of a team.

-Bilingual Spanish (read/write/speak) is a plus!

Job Type: Full-tim

Job Type: Full-time

Pay: $16.00 - $19.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Healthcare setting:

• Clinic
• Private practice

Medical specialties:

• Medical-Surgical
• Surgery

Schedule:

• 10 hour shift
• 8 hour shift
• Day shift
• Monday to Friday
• Weekend availability

Ability to commute/relocate:

• Bradenton, FL 34205: Reliably commute or planning to relocate before starting work (Required)

Education:

• High school or equivalent (Preferred)

Experience:

• Customer service: 1 year (Preferred)
• Medical terminology: 1 year (Preferred)
• Computer skills: 1 year (Preferred)

Work Location: In person

learninglandscape.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, learninglandscape.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, learninglandscape.com is the ideal place to find your next job.