What are the responsibilities and job description for the REIMBURSEMENT AND BILLING COORDINATOR position at Toledo Clinic?
General Summary:
Creates and maintains fee schedule files. Develop, test, and implement eCW applications. Monitor payor reimbursement and compliance. Assist medical offices and Business Services with fee schedules and unit fee pricing. Accountable for the TCI charge master. Support Administration and Credentialing with contracts. Perform fee analysis.
Principal Duties & Responsibilities:
1. Responsible for the update and control of the fee schedule files
2. Work with the Business Office staff to coordinate Payor issues between the Business Office, Insurance Carrier, and Medical Offices.
3. Maintain the TCI charge master by updating payor rates and monitoring necessary unit fee increases/decreases.
4. Generate payor analysis as requested by Administration/Contracting Committee.
5. Assist offices with any fee schedule issues they may have.
6. Work with IT and eCW testing new applications.
7. Pull contracting information as requested.
8. Communicate with Payors on issues regarding reimbursement
9. Other duties as assigned.
Required:
- Extensive knowledge of Excel pertaining to Formulas and Pivot Tables
- Working knowledge of a physician based medical office practice.
- Knowledge of physician coding and federal/state regulations of patient care.
- Consistently arrives at work, in professional attire, on time and completes all tasks within established time frame.
- Seeks appropriate tasks when primary tasks are completed and assists co-workers as needed.
- Demonstrates adaptability to expanded roles.
- Adheres to all clinic policies and procedures.
- HS diploma or GED, Medical billing
- Certified Coder or Associate degree in related field.