ASC Insurance Coordinator

ASC Insurance Coordinator

Qualifications

Job Description: ASC INSURANCE COORDINATOR 

General Summary: The ASC Insurance Coordinator works to ensure that all denials are worked in a timely manner and assist with claims filing and payment posting.  The ASC Insurance Coordinator is responsible for reviewing collected information to verify the accuracy and completeness of information. The ASC Insurance Coordinator works extensively with private insurers, as well as federal agencies such as Medicare and Medicaid, requiring the individual in this role to remain current on all rules and regulations that govern third party payment for medical services.  The ASC Insurance Coordinator also help work self pay account balances.  

Main Responsibilities: 

·         Responsible for ongoing review of open insurance claims and balances that have been appealed 

·         Sort claims by correct insurance/date of service/etc. to review outstanding accounts in Collectors Desktop 

·         Review unpaid charges, rejected charges and denied charges daily 

·         Appeal claims and follow through to completion 

·         Communicate any issues found with Management and update on resolutions 

·         Work on denial projects as assigned or on an ad hoc basis 

·         Handle department phone calls regarding claims and patient account balances 

·         Remain abreast of changing insurance practices, laws and guidelines 

·         Answer in depth billing questions, research patient inquiry to verify correct account for applying payment 

·         Posts insurance payments including contracted and non-contracted insurance carriers as needed to assist office manager 

·         Posts appropriate adjustments when required according to contract 

·         Copies primary EOB to file their secondary claims and file the secondary claim as needed to assist office manager 

·         Pull internal accounts and attach explanation of benefits (EOB’s) draw up refunds 

·         Review outstanding account balances to determine when the account will be turned over to an outside collection agency. 

·         Create and submit an electronic record of all accounts turned over to outside collection agency. 

·         Process patient and insurance refunds 

o   Filter negative account balance through Collectors Desktop to process refunds 

o   Complete check request to include Patient Demographic, copy of payment and copy of explanation of benefits (EOB’S) 

o   Review and follow through with all pending insurance credits 

·         Other duties as assigned 

Education/Experience/Knowledge: 

·         High School diploma or equivalent required 

·         3-4 years of experience in medical billing or claims denials 

·         Strict adherence to HIPAA guidelines and regulations with regard to providing highest levels of patient confidentiality 

·         Excellent written and verbal communication skills 

·         Attention to detail and the ability to concentrate 

·         Strong computer skills to include data entry 

·         Familiarity with EOB’s, CPT, ICD 10, claims, denials and appeals preferred 

Physical/Mental Demands: 
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Essential: Communication with others to exchange or express information and ideas. Ability to receive detailed information through oral communication, and to make fine distinctions in sounds. Determine the accuracy, neatness, thoroughness of the work assigned and perceive general observations. Must be able to remain in a stationary position at least 75% of the time. Extending the hands and arms in any direction. Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer. Perform a variety of duties, often changing from one task to another of a different nature. Perform with frequent interruptions and/ or distractions. Make appropriate job decisions following standard office policies and past precedents. Adjust priorities quickly as circumstances dictate. Ability to establish and maintain cooperative working relationships with co-workers and the public. Work independently and identify potentially more effective methods of work operations. Ability to interact appropriately with colleagues and patients for different purposes and different context. 

Marginal:  Needs to move inside or outside the office space to access file cabinets. Sedentary work that includes moving objects up to 10 pounds. Observing an area that can be seen up and down or to right or left while eyes are fixed on a given point. Ability to identify and distinguish colors. 

Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification.  They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Management reserves the right to revise the job or to require that other or different tasks be performed as assigned. 

All job requirements are subject to possible revision to reflect changes in the position requirements or to reasonably accommodate individuals with disabilities.