Address
Form of work There is a need for an Accounts Receivable Coordinator! This will be a contract to hire position.
Work onsite, Monday thru Friday from 8am until 5pm at the 3840 Hulen Street, Fort Worth 76107 location. Business casual attire is acceptable.
Minimum Qualifications
A. Education: High School Diploma or GED
B. Preferences: NA
C. Substitutions: One-year experience in medical billing and/or Accounts Receivable management
D. Years' Experience: 3 Years
E. Defined Experience: NA
F. License/Certifications: None Required
G. Special Courses: Knowledge of Medicare, Medicaid, Managed Care, Third Party Payers, Knowledge of National Universal (NUCC) and ANSI billing standards and legal standards or implications concerning billing and collection is preferred.
H. Supervisory Experience: Not Required
I. Regular and predictable work-site attendance, and punctuality is an essential function of this position.
J. Physical on-site presence, including regular attendance and punctuality, is an essential function of this position. Any changes or adjustments to your assigned work schedule or shift hours must be approved by your supervisor in advance.
I. Job Purpose
This position is responsible for Accounts Receivable management, resulting in a minimum collection ratio of 80% of billed services for assigned program funding sources. Functions include evaluating reimbursement levels, conducting claims appeals, filing of secondary claims, claims collection follow-up, processing of correspondence, electronic claims rejections, verifying benefit plan compliance, identifying adjustments, processing refunds, and resolution of client billing inquiries. The Senior A/R Coordinator serves as backup support and training for A/R Coordinators. The A/R Coordinator position assists the Accounts Receivable Manager on designated tasks as directed.
II. Essential Functions
A. Accurately verifies reimbursement levels.
1. Accurately verifies reimbursement levels within 7 days of receipt of posted monies by checking to see that levels are correct according to MHMR standards and the payer contract fee schedules and determine the action procedure to follow to find the appropriate standard and report back to payer for correct claim payment.
2. If collection was lower than what was billed, this position investigates problems with fee that constitutes lower payment and decides the action procedures to follow to accept or deny.
3. Accurately applies for additional monies or appeals for a higher payment level upon discovery of inaccuracy within 7 days of receipt of posted monies.
Performance Requirement(s):
B. Accurately performs appeals process to ensure that cash flow shortage is not experienced by MHMRTC.
1. Accurately documents denials and appeals actions in client's account "billing/collection notes" in MHMR's Accounts Receivable software.
2. Accurately generates and processes all appeal claims within 7 days of receipt and determines from the documentation the reason for the denial and communicates with proper authorities the details of the denial as it affects future billing processes.
3. Accurately submits additional information (i.e. prior claims disposition) with appealed claim if required. Knowledge of insurance terminology is needed to make decisions on what information is to be reported back to insurance payer to ensure future billing accuracy.
4. Initiates follow-up on all appealed claims within 45 days of filing by checking status of unpaid claims and calling insurance payer, Medicaid, commercial carriers, Medicare, or governmental managed care payer plans for all funding sources assigned.
C. Accurately files corrected or redirected primary and secondary claims.
1. Accurately generates and processes all claims (paper, electronic, online via payer website portal) to payers within 14 days of receipt or corrective data/payer info.
2. Accurately edits claims to payers.
3. Accurately submits prior claims disposition with new claim to secondary payers, after investigating and verifying that services are billed to correct payer. Clients may have two insurance companies (or payer sources), and this position must be constantly investigating this and other possibilities of coverage on clients to ensure that fees are changed accurately.
Performance Requirement(s):
D. Performs follow-up on outstanding insurance claims as assigned by Billing Manager
1. Accurately conducts insurance claims follow-up to resolve outstanding claims over 45 days old, which includes calling insurance payers for claims status. Claims can be paid status, pending status, or denied status, and this position must decide upon collecting status what action must follow to result in accurate and timely collections.
2. If claim is denied, this position must investigate all payers' standards for another eligible payer for the claim, contact other sources and bill for services.
3. Maintains not more than 30% of total insurance Accounts Receivable aged over 90 days.
4. Accurately submits a status report of A/R findings to Billing Manager within 4 weeks of issue.
5. Accurately documents all insurance claims follow up in MHMRTC's A/R software system.
6. Address and report unresolved claims payment issues for all managed care contracted payers to the Managed Care Sr. A/R Coordinator for documentation and tracking, HHSC compliant filing and resolution.
7. Recognize and report problem trends on payer account to the Billing and A/R Manager.
E. Maintains accurate self-pay balances as assigned and respond to billing and balance inquiries.
Performance Requirement(s):
1. Accurately transfer co-pays, deductibles and other cost shares to clients' self-pay accounts in MHMRTC's current A/R system.
2. Knowledgeable of HHSC requirements for the various programs' Charges for Community Services (Maximum Monthly Payment, Family Cost Shares, Percentage based rules.)
3. Knowledgeable of non- HHSC regulated standards for charging self-pay to clients (balance billing, contractual obligations, in network and out of network standards.)
4. Investigates and resolves billing inquiries concerning self-payer accounts within 4 days.
5. Maintains a professional rapport with program staff and individuals in the community and accurately documents client billing notes of all contacts.
6. Recognize and report problem trends on any payer account to the Billing and A/R Manager.
F. Processes correspondence.
Performance Requirement(s):
3. Obtains correct mailing address within 10 days of receipt.
4. Identifies and records adjustments required. Submits adjustments to Billing and A/R Manager for approval.
5. Accurately documents incoming correspondence and outcomes in client account billing notes in the A/R system 100% of the time.
G. Investigates verifies, processes electronic claims denials and rejections.
Performance Requirement(s):
1. Retrieves and prints electronic claim denials and rejections from payer response files or systems and/or other software applications monitoring reimbursement 100% of the time.
2. Analyzes output and identifies problems related to incorrect client data, missing provider information, service code misuse, and any format or coding inaccuracies.
3. Investigates problems and reports training needs to appropriate authorities or implements needed procedures and/or performs needed corrections resulting in a rejected/denied claim to bill to the appropriate payer the following week.
4. Appeals unpaid or short-paid claims within payer's timely appeal deadlines.
5. Recognizes and reports problem trends on participating accounts.
H. Reviews and accurately directs applications of unposted monies.
Performance Requirement(s):
1. Reviews unapplied monies and directs eligible funds for payment entry within 3 days of submission.
2. Generates reports from MHMRTC's A/R system indicating duplicate or inaccurate payments made that will need to be reimbursed to payer.
3. Processes eligible funds for refunds within 3 days of submission.
I. Verifies Third Party insurance.
Performance Requirement(s):
1. Obtains and verifies Third Party insurance if applicable.
2. Accurately updates insurance master file and client funding source information in MHMRTC's A/R system.
3. Upon receipt of insurance eligibility notice, fee assessment is reexamined and updated to reflect new coverage and eligibility.
4. Accurately documents verification findings in client billing notes 100% of the time.
J. Resolves client billing inquiries.
Performance Requirement(s):
1. Responds to community, agency or payer calls regarding billing inquiries within 3 days.
2. Double checks all billing entries by auditing client balances for accuracy daily and weekly as needed.
3. Performs appeals or adjustments necessary by recognizing the problem, corrects the problems immediately or investigates the entity responsible for handling the problem, and communicates with payer regarding the correct process for obtaining a solution.
4. Accurately documents client inquiries and outcomes in client billing notes.
K. Assists Billing and A/R Manager in projects.
Performance Requirement(s):
1. Generates requested reports in MHMR's payer and/or other software applications.
2. Analyzes output. Consults Billing and A/R and Sr. Managed Care A/R Coordinator with identified problems and aids in implementation of solutions.
3. Performs other office duties as required by Supervisor.
4. Attends weekly and monthly staff meetings.
III. Knowledge of Laws, Policies/Procedures, Skills, Education and Abilities
A. Knowledge of computers, printers, software, and network systems.
B. Knowledge of the principles of all automated office equipment.
C. Knowledge of the basic office skills: business terminology, spelling, punctuation, grammar, arithmetic, and filing systems.
D. Knowledge of medical claims processing, CPT coding, Medicare, Medicaid, CHIP and Managed Care billing regulations.
E. Knowledge of National Universal billing standards and legal standards or implications concerning billing.
F. Ability to type 35 words per minute.
G. Ability to train.
H. Ability to communicate effectively in both written and oral format.
I. Ability to prioritize workload.
J. Ability to identify problems and propose solutions.
K. Ability to establish and maintain effective working relationships with others and all levels of MHMRTC.
L. Ability to work independently on difficult or complex tasks and keep accurate records.
M. Ability to take directions and follow instructions.
N. Knowledge of MHMRTC Policies and Procedures
O. Knowledge of medical billing; paper and electronic claims filing including web-based applications
P. Third Party Billing Regulations
Q. Knowledge of word processing and spreadsheets software
IV. Internal & External Customer Service
This position requires regular contact with program staff and other Client Accounting staff member. Heavy contact with insurance companies, governmental payers, clients/guardians as needed. This position reports to the Billing and A/R Manager. The employee will accomplish this with average written and verbal skills.
Please share the bill rate for each submitted candidate. Those selected to move further in the process will be notified.
Work onsite, Monday thru Friday from 8am until 5pm at the 3840 Hulen Street, Fort Worth 76107 location. Business casual attire is acceptable.
Minimum Qualifications
A. Education: High School Diploma or GED
B. Preferences: NA
C. Substitutions: One-year experience in medical billing and/or Accounts Receivable management
D. Years' Experience: 3 Years
E. Defined Experience: NA
F. License/Certifications: None Required
G. Special Courses: Knowledge of Medicare, Medicaid, Managed Care, Third Party Payers, Knowledge of National Universal (NUCC) and ANSI billing standards and legal standards or implications concerning billing and collection is preferred.
H. Supervisory Experience: Not Required
I. Regular and predictable work-site attendance, and punctuality is an essential function of this position.
J. Physical on-site presence, including regular attendance and punctuality, is an essential function of this position. Any changes or adjustments to your assigned work schedule or shift hours must be approved by your supervisor in advance.
I. Job Purpose
This position is responsible for Accounts Receivable management, resulting in a minimum collection ratio of 80% of billed services for assigned program funding sources. Functions include evaluating reimbursement levels, conducting claims appeals, filing of secondary claims, claims collection follow-up, processing of correspondence, electronic claims rejections, verifying benefit plan compliance, identifying adjustments, processing refunds, and resolution of client billing inquiries. The Senior A/R Coordinator serves as backup support and training for A/R Coordinators. The A/R Coordinator position assists the Accounts Receivable Manager on designated tasks as directed.
II. Essential Functions
A. Accurately verifies reimbursement levels.
1. Accurately verifies reimbursement levels within 7 days of receipt of posted monies by checking to see that levels are correct according to MHMR standards and the payer contract fee schedules and determine the action procedure to follow to find the appropriate standard and report back to payer for correct claim payment.
2. If collection was lower than what was billed, this position investigates problems with fee that constitutes lower payment and decides the action procedures to follow to accept or deny.
3. Accurately applies for additional monies or appeals for a higher payment level upon discovery of inaccuracy within 7 days of receipt of posted monies.
Performance Requirement(s):
B. Accurately performs appeals process to ensure that cash flow shortage is not experienced by MHMRTC.
1. Accurately documents denials and appeals actions in client's account "billing/collection notes" in MHMR's Accounts Receivable software.
2. Accurately generates and processes all appeal claims within 7 days of receipt and determines from the documentation the reason for the denial and communicates with proper authorities the details of the denial as it affects future billing processes.
3. Accurately submits additional information (i.e. prior claims disposition) with appealed claim if required. Knowledge of insurance terminology is needed to make decisions on what information is to be reported back to insurance payer to ensure future billing accuracy.
4. Initiates follow-up on all appealed claims within 45 days of filing by checking status of unpaid claims and calling insurance payer, Medicaid, commercial carriers, Medicare, or governmental managed care payer plans for all funding sources assigned.
C. Accurately files corrected or redirected primary and secondary claims.
1. Accurately generates and processes all claims (paper, electronic, online via payer website portal) to payers within 14 days of receipt or corrective data/payer info.
2. Accurately edits claims to payers.
3. Accurately submits prior claims disposition with new claim to secondary payers, after investigating and verifying that services are billed to correct payer. Clients may have two insurance companies (or payer sources), and this position must be constantly investigating this and other possibilities of coverage on clients to ensure that fees are changed accurately.
Performance Requirement(s):
D. Performs follow-up on outstanding insurance claims as assigned by Billing Manager
1. Accurately conducts insurance claims follow-up to resolve outstanding claims over 45 days old, which includes calling insurance payers for claims status. Claims can be paid status, pending status, or denied status, and this position must decide upon collecting status what action must follow to result in accurate and timely collections.
2. If claim is denied, this position must investigate all payers' standards for another eligible payer for the claim, contact other sources and bill for services.
3. Maintains not more than 30% of total insurance Accounts Receivable aged over 90 days.
4. Accurately submits a status report of A/R findings to Billing Manager within 4 weeks of issue.
5. Accurately documents all insurance claims follow up in MHMRTC's A/R software system.
6. Address and report unresolved claims payment issues for all managed care contracted payers to the Managed Care Sr. A/R Coordinator for documentation and tracking, HHSC compliant filing and resolution.
7. Recognize and report problem trends on payer account to the Billing and A/R Manager.
E. Maintains accurate self-pay balances as assigned and respond to billing and balance inquiries.
Performance Requirement(s):
1. Accurately transfer co-pays, deductibles and other cost shares to clients' self-pay accounts in MHMRTC's current A/R system.
2. Knowledgeable of HHSC requirements for the various programs' Charges for Community Services (Maximum Monthly Payment, Family Cost Shares, Percentage based rules.)
3. Knowledgeable of non- HHSC regulated standards for charging self-pay to clients (balance billing, contractual obligations, in network and out of network standards.)
4. Investigates and resolves billing inquiries concerning self-payer accounts within 4 days.
5. Maintains a professional rapport with program staff and individuals in the community and accurately documents client billing notes of all contacts.
6. Recognize and report problem trends on any payer account to the Billing and A/R Manager.
F. Processes correspondence.
Performance Requirement(s):
- Replies and /or sends program or payer correspondence within 7 days of receipt.
3. Obtains correct mailing address within 10 days of receipt.
4. Identifies and records adjustments required. Submits adjustments to Billing and A/R Manager for approval.
5. Accurately documents incoming correspondence and outcomes in client account billing notes in the A/R system 100% of the time.
G. Investigates verifies, processes electronic claims denials and rejections.
Performance Requirement(s):
1. Retrieves and prints electronic claim denials and rejections from payer response files or systems and/or other software applications monitoring reimbursement 100% of the time.
2. Analyzes output and identifies problems related to incorrect client data, missing provider information, service code misuse, and any format or coding inaccuracies.
3. Investigates problems and reports training needs to appropriate authorities or implements needed procedures and/or performs needed corrections resulting in a rejected/denied claim to bill to the appropriate payer the following week.
4. Appeals unpaid or short-paid claims within payer's timely appeal deadlines.
5. Recognizes and reports problem trends on participating accounts.
H. Reviews and accurately directs applications of unposted monies.
Performance Requirement(s):
1. Reviews unapplied monies and directs eligible funds for payment entry within 3 days of submission.
2. Generates reports from MHMRTC's A/R system indicating duplicate or inaccurate payments made that will need to be reimbursed to payer.
3. Processes eligible funds for refunds within 3 days of submission.
I. Verifies Third Party insurance.
Performance Requirement(s):
1. Obtains and verifies Third Party insurance if applicable.
2. Accurately updates insurance master file and client funding source information in MHMRTC's A/R system.
3. Upon receipt of insurance eligibility notice, fee assessment is reexamined and updated to reflect new coverage and eligibility.
4. Accurately documents verification findings in client billing notes 100% of the time.
J. Resolves client billing inquiries.
Performance Requirement(s):
1. Responds to community, agency or payer calls regarding billing inquiries within 3 days.
2. Double checks all billing entries by auditing client balances for accuracy daily and weekly as needed.
3. Performs appeals or adjustments necessary by recognizing the problem, corrects the problems immediately or investigates the entity responsible for handling the problem, and communicates with payer regarding the correct process for obtaining a solution.
4. Accurately documents client inquiries and outcomes in client billing notes.
K. Assists Billing and A/R Manager in projects.
Performance Requirement(s):
1. Generates requested reports in MHMR's payer and/or other software applications.
2. Analyzes output. Consults Billing and A/R and Sr. Managed Care A/R Coordinator with identified problems and aids in implementation of solutions.
3. Performs other office duties as required by Supervisor.
4. Attends weekly and monthly staff meetings.
III. Knowledge of Laws, Policies/Procedures, Skills, Education and Abilities
A. Knowledge of computers, printers, software, and network systems.
B. Knowledge of the principles of all automated office equipment.
C. Knowledge of the basic office skills: business terminology, spelling, punctuation, grammar, arithmetic, and filing systems.
D. Knowledge of medical claims processing, CPT coding, Medicare, Medicaid, CHIP and Managed Care billing regulations.
E. Knowledge of National Universal billing standards and legal standards or implications concerning billing.
F. Ability to type 35 words per minute.
G. Ability to train.
H. Ability to communicate effectively in both written and oral format.
I. Ability to prioritize workload.
J. Ability to identify problems and propose solutions.
K. Ability to establish and maintain effective working relationships with others and all levels of MHMRTC.
L. Ability to work independently on difficult or complex tasks and keep accurate records.
M. Ability to take directions and follow instructions.
N. Knowledge of MHMRTC Policies and Procedures
O. Knowledge of medical billing; paper and electronic claims filing including web-based applications
P. Third Party Billing Regulations
Q. Knowledge of word processing and spreadsheets software
IV. Internal & External Customer Service
This position requires regular contact with program staff and other Client Accounting staff member. Heavy contact with insurance companies, governmental payers, clients/guardians as needed. This position reports to the Billing and A/R Manager. The employee will accomplish this with average written and verbal skills.
Please share the bill rate for each submitted candidate. Those selected to move further in the process will be notified.
