Eye Associates of New Mexico has an outstanding career opportunity within our Patient Accounting Team!POSITION SUMMARY:Verifies patient insurance and eligibility for upcoming appointments and past appointments to include updating, accessing eligibility resources and researching denials of coverage. Analyzes denials to identify trends and errors and educates staff to decrease future denials. Creates and maintains insurance educational material that is available for staff. Serves as liaison for clinical staff regarding insurance questions. Provides educational guidance to clinic staff members, in cooperation with the training department, aimed at improving the quality of claim submission and reducing the number of denials. The Pt Insurance Coordinator must take the EANM Insurance Certification within one year in role. The Pt Insurance Coordinator is encouraged to complete one of the following certification: Certified Patient Services Specialist (CPSS) OR Ophthalmic Coding Specialist Certification (OCS) OR Certified Professional Biller (CPB) OR Certified Professional Coder (CPC).ESSENTIAL FUNCTIONS/RESPONSIBILITIES:
On a daily basis, enters all patient information/scheduled surgeries for multiple locations within the Facility Registration/Scheduling system.
Coordinates financial clearance for all patients to include pre-registration, eligibility and benefits, referral coordination, authorization requirements and expressing financial expectations using on-line systems, telephonic verification, and faxing to update and verify patient demographic and payer information.
Ensures all registration and financial data in the Facility Registration System are up to date with accurate data.
Responsible for the correct identification and selection of appropriate insurance plans.
Performs follow-up functions to correct inaccurate/missing data elements.
Responds to telephone inquiries, questions, situations related to registration practices, billing and insurance requirements in a timely, effective and professional manner.
Pre-Registration: communicates effectively with patients regarding their patient financial responsibility as well as collects copays, deductibles and co-insurance prior to date of service.
Advises supervisor/manager of problems and potential problems as soon as possible.
Takes ownership of all appointments assigned. Personal actions demonstrate accountability for the outcomes of the facility.
Works closely with supervisors, clinic directors, physicians and all members of the physician office/surgery center to resolve problems or issues related to patient's registration, financial issues or authorization issues. Notifies the appropriate physician's office of patient's inability to meet their estimated financial obligation/authorization requirements within timeline outlined prior to date of service to determine need to reschedule or proceed.
Follows work prioritization standards as established, using standard tools to complete work in the most effective manner established and enters appropriate account status codes. Documents work activity clearly, concisely and completely.
Assists in training of new and additional personnel and provides for coverage as needed.
Applies skills, knowledge, abilities and utilizes reporting tools in order to meet performance and productivity standards as defined by workloads.
Performs all other duties as assigned.
The annual completion of assigned Learning Management System (LMS) courses is mandatory. Any individual who has not completed their assigned training prior to November 30th of each year may be subject to disciplinary action, up to and including termination of employment.
SKILLS/QUALIFICATIONS:
High School Diploma or Equivalent
Experience w/ Microsoft Office Products (Excel, Office, Outlook, etc.)
Knowledge and understanding of Medical Terminology, CPT Codes, and ICD-10 Codes
Experience w/Next Gen, Advantx, and/or Compulink
Strong Typing and Ten Key skills
Strong Communication Skills
1 year related experience
EANM Insurance Certification - Must pass within 1st year in position
Encouraged to attain one of the following Certifications:
Certified Patient Services Specialist (CPSS) OR
Certified Professional Biller (CPB)
GENEROUS BENEFITS:
Career Path
Higher pay in areas where the cost of living is higher
Paid time off (PTO)
Eight (8) company paid holidays (including the day after Thanksgiving and Christmas Eve!)
Medical and Dental
Generous Vision benefits for you and your dependents
Education Assistance Program
Uniform (scrub) allowance
Company provided logo apparel
401(k) and Roth Program
Flexible Spending Account (FSA)
Company paid Basic Life and AD&D Insurance, Short Term and Long Term Disability Insurance
Voluntary Supplemental Life and AD&D
Free Calm app
Financial Wellness Program
Identity Theft Protection Plan
Employee Assistance Program
and more!
Please visit us at for more informationAA/EOE/Disability. Eye Associates of New Mexico is a drug and tobacco-free employer.Req 2725
