Approval Billing Coordinator

Elevate Patient Financial Solutions has an exciting career opportunity available as an Approval Billing Coordinator. This position will be Remote Work from Home. The Full-Time schedule for this role will be Monday through Friday, 7:00am - 3:30pm PST; 9:00am to 5:30pm CST.

Job Summary

The purpose of this position is to ensure company standards in place are met to meet the client’s contractual obligations. The position oversees all aspects of the approval, billing audit and business code assignment for assigned hospital clients. This includes auditing, invoice validation, linking to correct benefit programs, reclassification in the hospital system to ensure approvals and billing are initiated timely, with identifying approval and billing trends of the appropriate hospital systems.

Essential Duties And Responsibilities

• Required to learn a variety of hospital systems and user interfaces.
• Assure all tasks and projects assigned are completed timely.
• Assist in the final invoice auditing process. Ensure the accuracy of the invoices; work with the corporate billing department to resolve issues or concerns identified.
• Perform Eligibility and TAR approvals, reclassifying with correct insurance, document, updating billing indicators, and updating authorization eligibility to ensure the correct insurance will be billed for the patient’s date(s) of service.
• Aged approved audits on assigned hospitals are submitted to RVP’s and leadership monthly.
• Responsible for assigned active, closed, approved inventories and making sure reclassification is correct.
• Monitor and verify the hospitals have reclassified the account when approved and/or reclassifying for selected hospitals.
• Perform ongoing audits on assigned hospitals. Reconciliation with PAT, hospital system and MPower identifying any errors or inconsistencies, staff advocates issues, and delays or trends.
• Provide results to hospital on a periodic basis.
• Communicate on problem accounts and resolving with hospital staff if appropriate as well as aged approved accounts.
• Monitor company’s performance and proactively identify risks and communicate to management.
• All risks are identified and reviewed for quality control evaluations.
• Ensures payments fall within the parameters of the hospital contract.
• Audit and verify assign activity business codes in MPower to ensure accurate payment for assigned clients match PAT.
• Progress accounts to a billed status if Elevate PFS completed the work.
• Verify and update information required on the “Update log.”
• Identify approval/billing trends that impact the client and/or internal operations.
• Summarize the findings and communicate directly with the Billing Manager for review.
• Assist in the final invoice auditing process. Ensure the accuracy of the invoices; work with the corporate billing department to resolve issues or concerns identified.
• Other duties as assigned.
  
  
  

Qualifications And Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.

• Bachelor’s Degree Preferred or equivalent.
• Dependable and highly detailed.
• Knowledge of government healthcare programs.
• High comfort level working in a time sensitive, diverse, and fast-paced environment.
• At least 1-year clerical experience in healthcare setting preferred.
• Self-driven, results oriented with a positive outlook, and a clear focus on high quality and business profit.
• Facilitate in depth audits of hospitals.
• Set an example for follow up of aging accounts.
• Ability to work under pressure, meets deadlines, make sound decisions, analytical skills, time management, and possess strong problem-solving skills.
• Excellent people person, open to direction and willing to work collaboratively to get the job done.
• Ability to research trends and address positive/negative trends timely.
• Set an example for follow up of aging accounts.
• Uses personal judgment and initiative to develop effective and constructive solutions to challenges and obstacles in company procedures and client, patient activities.
• A natural forward planner who critically assess own performance.
• Ability to work independently and on a team.
• Ability to prioritize and handle multiple tasks in a changing work environment while still meeting required deadlines.
• Willingness to learn new systems and functions.
• Excellent written and verbal communication skills required.
• Comfortable with repetitive work.
• Possess a high level of integrity – must show good judgement and confidentiality at all times.
• Proficient with Internet and MS Office software (Excel, Word).
• Remote and Hybrid positions require a home internet connection that meets the company’s upload and download speed criteria.
  
  
  

Benefits

ElevatePFS believes in making a positive impact not only within our industry but also with our employees –the organization’s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.

• Medical, Dental & Vision Insurance
• 401K (100% match for the first 3% & 50% match for the next 2%)
• 15 days of PTO
• 7 paid Holidays
• 2 Floating holidays
• 1 Elevate Day (floating holiday)
• Pet Insurance
• Employee referral bonus program
• Teamwork: We believe in teamwork and having fun together
• Career Growth: Gain great experience to promote to higher roles.
  
  
  

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.

The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

ElevatePFS is an Equal Opportunity Employer