Job Summary:
The Medicare Coordinator is responsible for coordinating the daily activities regarding account follow-up and collections of Medicare accounts.

Education:
Required: High School diploma or equivalent.

Preferred:
AA
CPAR

Experience:
Required:
Minimum of three years experience in billing in a hospital business office required. Insurance knowledge required with a clear knowledge of benefits, contracts, co-pays, deductibles, and adjustments. Supervisory experience required. General knowledge of Medicare, Medicaid, third-party payer payment regulations/mechanisms for payment and compliance. General knowledge of ICD-9, CM, CPT, and HCPCS coding regulations. Extensive knowledge of Medicare and commercial billing requirements for all bill types including knowledge of UB92 and 1500 requirements.

Preferred:
N/A

Position Requirement(s): License/Certification/Registration
Required:
None

Preferred:
N/A

Department Position Summary:
The Medicare Coordinator is responsible for coordinating the daily activities regarding account follow-up and collections of Medicare accounts. He/She is also responsible for planning, implementing, and maintaining all functions pertinent to the follow-up area. Responsible for developing and evaluating staff and updating policies and procedures relating to Medicare account follow-up and collections. Responsible for maintaining timely and proper follow-up on Medicare accounts for timely reimbursement and denials. Works closely with Education Specialist to provide timely education and training of staff regarding current issues and changes in collections and compliance that may impact reimbursement. Responsible for sampling fifteen accounts p/collector on a weekly basis to ensure that staff is following proper follow-up procedures and productivity goals are being attained. The Medicare Coordinator will conduct themselves in a professional manner, promote harmony through a teamwork environment, attend Medicare training and workshops deemed necessary and endeavor to support the goals and objectives as outlined by department and organization. Discusses any unusual problems or circumstances with the PFS Support Manager and performs other duties as assigned.