Employment Type:

Shift:

Description:

Position Overview 

The Prebilling Audit Coordinator is responsible and accountable for the processing of all regulated billing documentation meeting HCFA/MCC/JCAHO regulations and guidelines.  Primary responsibilities include processing all front-end documentation needed to meet month end deadlines assuring accurate billing.  In addition, monitors all branch regulated accounts for optimal reimbursement and compliance per agency policy.  This position works closely with the Business/Facilities Manager and THAH Collection analyst in the tracking of untimely documentation and resolution of problematic billing issues.  Acts as the liaison between the Service Center and the agency to assure the compliance of the physician’s orders. 

 What You Can Expect: 

• Consistent, Reliable Workloads 
  Enjoy steady assignments with guaranteed hours—no surprises. 

• Competitive Pay & Low-Cost Benefits 
  Get exceptional coverage and real savings that make a difference. 

• Supportive Leadership 
  Our management team is here to help you succeed every step of the way. 

• Career Growth Opportunities 
  Every leader on our team started in a field role—your path to leadership starts here. 

• Fast Hiring Process 
  Quick interviews and job offers because your time matters. 

What Will You Do:

• Apply a current working knowledge of applicable Federal, State and local laws and regulations, Trinity Health Organization Integrity Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

• Prepares and enters data into the appropriate software, assuring the accuracy of the regulated client account following all regulations placed on the homecare agency.  Ensures that input of information is accurate, and paperwork is received timely for the submission of claims.  Responds to all system issues by preparing documentation for the resolution center.  Timely submission of OASIS/HIS to the state to ensure accurate billing.  Reviews and Analyzes submission reports to address errors.

• Generates all billing documentation needed to be billed in a timely manner assuring industry standards are met.  Monitors and processes the Perform Billing Audit Report, Pre-Billing Validation and Unbilled Report on a weekly basis to ensure timely and clean billing.

• Coordinates PCR tracking log and communicates issues related to PCR held AR to the PCR team.

• Coordinates monthly insurance verification for all payers.  This includes reading and interpreting payer websites for accurate information, communicating changes to clinical and billing colleagues.  Facilitate all payer changes to reduce risk of write-off due to untimely processing.

• Utilizing the CQI Process Improvement technique, responsible for implementing and monitoring changes to processes to ensure continued integrity of client accounts.  Collaborate with the Intake Department to identify processes for improvement ensuring the accuracy of the billing process.

• Provides statistical feedback regarding the status of unbilled claims to THAH Revenue team on a weekly basis or as defined by policy. 

• Interfaces with THAH to resolve problems related to the processing of bills/claims.  Investigates client accounts at the request of THAH and provides any additional documentation required. 

• Seeks assistance from Clinical Team Leaders and/or Business/Facilities Manager with clinical data entry and/or billing problems.

• Coordinates the flow of billing related paperwork between the branch and THAH Service Center.  Works with the branch and THAH colleagues to identify areas of improvement related to billing.  Actively participates in all billing conference calls between the agency and THAH.

Minimum Qualifications: 

• The incumbent can articulate and demonstrate a commitment to the mission, vision and values of Trinity Health and to inspire active support of these in others.

• The preferred candidate will have a high school diploma or GED.

• College business courses or an associate’s degree is preferred, or four to six years of experience in a medical billing office setting.

• A strong knowledge of general office functions, strong analytical and organizational skills and microcomputer usage are required.

• Incumbents must possess the following: ability to meet strict deadlines with high level of accuracy, ability to prioritize multiple tasks in highly automated settings, and possess str