Job Description

NO OUT OF STATE APPLICANTS PLEASE.

ONLY APPLICANTS LOCATED IN ILLINOIS WILL BE CONSIDERED .

JOB DESCRIPTION

Perform a variety of administrative duties which include billing claims, correct rejected claims

and follow up on them. Responsible for monthly goals in Accounts receivable pertaining to your

payor. Work with other team members within the billing department and operations to ensure billing

is done accurately. The Insurance Reimbursement Coordinator is responsible for all billing and

verifying receipt of all claim files

submitted.

DUTIES AND RESPONSIBILITIES include the following. Other duties may also be assigned.

Reviews daily census and Insurance eligibility verification. Make sure payor changes are

accurate.

Identifies and communicates errors, issues, and trends to the department Supervisor and/ or

Lead and other concerned individuals.

Reviews, edits and make necessary corrections to claims before submission and transmit claims using

billing software, including electronic and paper claim processing.

Bills claims by editing any errors and once cleared, exports them through PCC. Once exported to

Emdeon , rechecks the claims in Emdeon to see if there are any rejected, held or incomplete

ones.

Follows up on unpaid claims within the standard billing cycle timeframe. Follows up on outstanding

balances for all payors by making calls to the insurance carriers for claim status.

Works the aging for each facility.

Follows procedures and fill out forms to request Ledger adjustments and bad debt write offs. Follow

up to ensure they are done and off your A/R.

Answers all resident's or any inquiries pertaining to payor guidelines.

Makes all payor corrections and adjustments when necessary to all claims in PCC System and Emdeon

in a timely manner.

Requests Medical records when needed and follows up on requests.

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