Business Office Coordinator

hace 4 semanas


San Juan, San Juan, Puerto Rico Hospital San Juan Capestrano A tiempo completo
Purpose and Scope

The Business Office Coordinator plays a critical role in ensuring the accurate and timely documentation of insurance verification, billing, and collections at Hospital San Juan Capestrano. This position requires a high level of attention to detail and organizational skills to maintain a correct account balance and prevent accounts from becoming delinquent or remaining unbilled.

Key Responsibilities
  • Verify and interpret insurance benefits and establish financial arrangements with guarantors/patients.
  • Estimate patient out-of-pocket expenses and make financial arrangements with guarantors/patients.
  • Post payments and follow up on claims.
  • Prepare and review all billing forms to ensure accuracy and completeness for claims submission to insurance carriers and backup for Medicare and Medicaid claims.
  • Process claims electronically or by hard copy with 100% accuracy and mail claims to insurance carriers timely.
  • Enter documentation and adjustments through the computer system to maintain a correct account balance.
  • Update system information according to correspondence received and processed, documenting any changes and submitting to appropriate staff.
  • Review charge summaries on each patient bill produced and identify discrepancies with 100% accuracy.
  • Consistently apply appropriate procedures to prevent accounts from becoming delinquent or remaining unbilled.
  • Initiate appropriate follow-up and collection calls.
  • Review remittance advice statements for payments and adjustments on a daily basis and initiate appropriate data entry for patient charge or account discrepancies on review.
  • Identify denial and pending reasons and investigate, resolve, and initiate information to secure reimbursement.
Requirements
  • High school diploma or equivalent required.
  • At least 3 years' experience in a related field.
  • Extensive knowledge and understanding of Commercial Insurance and Medicare/Medicaid.


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