Repetitive Patient Coordinator

Essential Duties and Responsibilities :

Check eligibility and benefits verification

Contacting nursing home, physicians, patients, and various other facilities to secure PCS forms

Develop strong relationships with healthcare partners in the communities we serve

Maintain the patient activity log for all repetitive patients on the shared drive

Coordinate with Dispatch to ensure timely feedback of transports that do not meet medical necessity

requirements for governmental payers

Escalate any areas of non-compliance to PMBS Repetitive Patient Team Leadership

Schedule claims for billing using billing software

Following up on unpaid claims within standard billing cycle timeframe

Processing incoming mail and taking appropriate follow up actions to resolve accounts

Researching and appealing denied claims

Answer telephone inquiries from the patient or insurance companies

Contacting the patient to escalate issues regarding their ambulance transports

Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Performing other duties as assigned.

Qualifications : Proficient with a PC

Proficient with a PC

Knowledge of Health Insurance Portability and Accountability Act (HIPAA)

Knowledge of procedure and diagnostic codes (HCPCS and ICD-10 codes)

Knowledge of medical terminology

Knowledge of Medical Billing

Knowledge of insurance guidelines including HMO / PPO, Medicare, Medicaid, and commercial payers

Customer service skills for interacting with patients regarding medical claims and payments, including

communicating with patients and family members of diverse ages and backgrounds.

Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections

Ability to work independently and with a group

Working knowledge of MS Word, Excel

Ability to maintain effective working relationships.

Thorough knowledge of office practice

Ability to type at least 35 words per minute.

Proficiency using 10 key

Education and Experience Requirements :

High School Diploma or GED

Must have excellent verbal and written communication skills. Requires effective customer relation skills, ability to

organize and interpret data.

Minimum of three year revenue cycle management experience or related clinical experience preferred.

Experience working with MDS documentation or nursing home related experience.

Medical Assistant or Licensed Practical Nurse preferred with knowledge of prior authorization and medical

necessity.

Physical Requirements :

Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other

federal, state and local standards, including meeting qualitative and / or quantitative productivity standards.

Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local

standards.

The employee may occasionally be required to lift and / or move up to 20 pounds.

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision,

depth perception, and the ability to adjust focus.

Work may require sitting, lifting, stooping, bending, stretching, walking, standing, pushing, pulling, reaching, and

other physical exertion.

Must be able to talk, listen and speak clearly on telephone.

Must possess visual acuity to prepare and analyze data and figures, operate a computer terminal, and operate a

motor vehicle.

Travel Time : Negligible

NOTE : The above statements are intended to describe the general nature and level of work being performed by the

person assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, skills and

physical demands required of personnel so classified.