Billing Coordinator - CTI Pulmonology and Thoracic Surgery (hybrid)

Company Description

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

Job Description

• • Performs charge capture for all procedures completed in the Bronchoscopy suite. This includes:
    • Audit of CPT codes associated with each procedure
    • Confirmation of supplies used and verification of alignment with operative notes
  • Assists patients with billing and insurance related matters including communicating with patients regarding balances owed and other financial issues and facilitating collection of balances owed.
  • Educates patients about financial assistance opportunities, insurance coverage, treatment costs, and clinic billing policies and procedures.
  • Collaborates closely with physicians and technicians to understand treatment plans and determine costs associated with these plans; Works closely with the staff on managed care and referral related issues; communicates findings to patients.
  • Coordinates the pre-certification process with the clinical staff as it relates to procedures in the Bronchoscopy Suite and Operating Rooms
  • Handles billing inquiries received via telephone or via written correspondence.
  • Responsible for thoroughly investigating and understanding financial resources or programs that may be available to patients and educating staff and patients about these programs.
  • Conducts precertification for appropriate tests or procedures and facilitates the process with managed care and the clinical team. Documents all information and authorization numbers in Epic and acts as a liaison for follow-up related to precertification.
  • Performs activities and responds to patient inquiries related to billing follow-up.
  • Requests necessary charge corrections.
  • Identifies patterns of billing errors and works collaboratively with department manager and outside entity to improve processes as needed.
  • Provides guidance regarding clinical documentation to optimize charges and RVUs
  • Confirms coding accuracy based on clinical documentation and reviews common errors or misses with physicians and leadership.

The Billing Coordinator reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

The Billing Coordinator is responsible for processing charges, payments and/or adjustments for all services rendered at all NM Corporate Health Clinics. Researches and follows- up on all outstanding accounts. Answers all calls regarding charges and claims, providing exceptional customer service to all callers. Possesses extensive knowledge of coding, billing, insurance and collections procedures and coordinates the accounts receivable functions. Performs weekly claims, monthly late bills and patient statement runs and reviews accounts to be placed with an outside collection agency.

RESPONSIBILITIES:

Department Operations

• Ensures patient demographic and billing/insurance information is kept current in the computer application. Documents all patient and company contacts.
• Reviews daily clinic schedules and tracks receipt of documentation to assure completeness of charge capture.
• Ensures notes are is placed in systems, clearly identifying steps taken, according to established procedures.
• Works with patients/clients to establish payment plans according to predetermined procedures.
• Handles all incoming customer service calls in a professional and efficient manner. Provides exceptional service to all customers, guarantors, patients, internal and external contacts.
• Prepares itemized bill upon request; explains charges, payments and adjustments. Produces a clear and understandable statement to individuals on any outstanding account balance.
• Responsible for timely submission of accurate bills and invoices to clients, patients and insurance companies.
• Ensures timely posting of all charges, payments, denials and write-offs to the appropriate account, maintaining the highest level of quality for each transaction processed within 48 hours of receipt.
• Responsible for balancing each payment and adjustment batch with reconciliation report and bank account deposits after completion.
• Ensures compliant follow up procedures are followed, to third party payers regarding outstanding accounts receivables.
• Run outstanding A/R reports, follow-up on unpaid claims or balances with insurance companies, patients, and collection agency, as defined by department.
• Perform daily systematic review of accounts receivable to ensure all accounts ready to be worked are completed.
• Recommend accounts for contractual or administrative write-off and provide appropriate justification and documentation.
• Denials and appeals follow-up including root cause analysis to reduce/prevent future denials.
• Reviews, prepares and sends pre-collection letters as defined by department procedures.
• Identifies and sends accounts to outside collection agency.
• Prepares and distributes reports that are required by finance, accounting, and operations.
• Handles all work in an accurate and timely manner, consistently meets or exceeds productivity standards, quality standards, department goals and deadlines established by the team.
• Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices.
• Identify opportunities for process improvement and submit to management.
• Demonstrate proficient use of systems and execution of processes in all areas of responsibilities.

Communication and Teamwork

• Fosters and maintains positive relationships with the Corporate Health team, Human Resources, NM employees and physicians.
• Provides courteous and prompt customer service. Answers the telephone in a courteous professional manner, directs calls and takes messages as appropriate. Checks for messages and returns calls.
• Demonstrates teamwork by helping co-workers within and across departments. Communicates effectively with others, respects diverse opinions and styles, and acknowledges the assistance and contributions of others.
• Communicates appropriately and clearly to physicians, manager, nursing staff, front office staff, and employees. Maintains a good working relationship within the department. Organizes time and department schedule well. Demonstrates a positive attitude.

Service Excellence

• Displays a friendly, approachable, professional demeanor and appearance.
• Partners collaboratively with the functional areas across Northwestern Medicine in support of organizational and team objectives.
• Fosters the development and maintenance of a cohesive, high-energy, collaborative, and quality-focused team.
• Supports a “Safety Always” culture.
• Maintaining confidentiality of employee and/or patient information.
• Sensitive to time and budget constraints.
• Other duties as assigned.

Qualifications

Required :

• High school graduate or equivalent.
• Strong Computer knowledge, data entry skills in Microsoft Excel and Word.
• Thorough understanding of insurance billing procedures, ICD-10, and CPT coding.
• 3 years of physician office/medical billing experience.
• Ability to communicate clearly and effectively, both orally and in writing, at all levels within and outside the organization.
• Ability to work independently.

Preferred :

• 3 years of physician office/medical billing experience in Corporate Health/Occupational Health a plus.
• CPC (Certified Professional Coder) or R (Registered Medical Coder) Certificate a plus.

Additional Information

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

If we offer you a job, we will perform a background check that includes a review of any criminal convictions. A conviction does not disqualify you from employment at Northwestern Medicine. We consider this on a case-by-case basis and follow all state and federal guidelines.

Benefits

We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.