Insurance Coordinator HME

Responsible for submitting accurate, clean claims to third parties and private pay accounts, collecting and posting payments to patients' accounts, and following up on unpaid/incorrectly paid claims through to resolution.

Responsibilities

1. Register all new patients into the computer system, ensuring all necessary information is added.
2. Analyze physician orders, certificates of medical necessity, or prescriptions submitted by physicians for proper documentation to ensure compliance with insurance billing regulations. Obtain additional information from the physician's office when necessary.
3. Track and obtain renewal of physician orders/CMNs for recurrent orders as necessary.
4. Prepare patient charges for billing.
5. Review claims for accuracy prior to submission.
6. Review all payments for accuracy, post payments to patient accounts, and make adjustments as needed.
7. Analyze incorrect payments and denied claims, then resubmit with additional information as necessary.
8. Use aging reports to track and follow up on unpaid claims, resubmitting with additional information as needed.
9. Perform typing and clerical tasks related to the above duties.
10. Perform all other related duties as assigned.

Job Qualifications and Specifications:

A High School diploma and at least one year of related experience or equivalent is required.

Care New England Health System (CNE) and its member institutionsButler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Groupare trusted organizations advancing medical research, attracting top specialists, and providing innovative health services.

Americans with Disabilities Act Statement: External and internal applicants, as well as incumbents who become disabled, must be able to perform essential job functions either unaided or with reasonable accommodations, as determined on a case-by-case basis.

EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Ethics Statement: Employees must conduct themselves in accordance with organizational ethical standards, including hospital policies, mission, vision, and values.