Balance Billing Coordinator II (Managed Care Health Claims)
Location: New York New York
Description: 1199SEIU Funds is presently looking of Balance Billing Coordinator II (Managed Care Health Claims) right now, this position will be placed in New York. For complete informations about this position opportunity please give attention to these descriptions. The 1199SEIU Benefit & Pension Funds provide comprehensive health, pension, and quality of life benefits to unionized workers represented by 1199SEIU United Healthcare Workers East. We are among the largest labor-management funds in the nation, covering 400,000 members and their families.
If you’re ready for the brightest career future, join us in this excellent opportunity to showcase your talents. We are currently seeking an experienced Balance Bill! ing Coordinator II (Managed Care Health Claims) f or our Balan! ce Billing department.
Responsibilities
- Assist and educate 1199SEIU members and providers with out of network fees and out of pocket expenses on the member choice program, contracts, and benefits of using the Funds network
- Negotiate and resolve large volume of balance billing inquires, negotiate fees and discounts for members with non-participating providers via telephone and written correspondence; maintain ongoing communication with providers, members, attorneys, or collection agencies to resolve balance billing/fee negotiation inquiries
- Administer, design, and manage various Access databases; evaluate and implement new Access databases, research, troubleshoot, provide database solutions, and create reports on negotiated settlements by Current Procedural Terminology (CPT) codes and provider tax identification
- Produce monthly, quarterly and annual reports to identify trends, analyze and audit balance billing data while devel! oping & maintaining Excel spreadsheets to provide recommendations for improvement
- Complete purchase orders via Financial and Procurement System (Oracle); ensure all documents are processed in a timely and efficient manner
- Update Balance Billing Team regarding member needs and balance billing issues; provide solutions to improve productivity, reduce time spent on inquiries, track members/providers who repeatedly go out of network; accurately track inquiries from receipt to completion
- Assign, audit work, and review staff production to ensure standards and approved time frames are being met and are uniformed when negotiating settlements; assist staff in developing procedures, forms, and database maintenance
- Assess and compute Reasonable and Fair rates utilizing Fair Health databases to negotiate claim payments, between members, provider, collection agencies and attorneys
- Perform additional duties and projects as assigned by manageme! nt
- High School Diploma or GED re! quired, some College or Degree preferred; plus
- Minimum two (2) years experience in provider relations, balance billing, or health claims; to include two (2) years experience negotiating medical and hospital claims for managed care plans required
- Intermediate skill level with Microsoft Access and Excel required - ability to conduct various data comparison analysis, working knowledge of macros, tables, forms, queries and reports a must; knowledge of health claims processing systems (QNXT & Syntonics) a plus
- Excellent knowledge of health claims, eligibility rules, Coordination of Benefits (COB), and 1199SEIU Benefit and Pension Fund benefits; experience with settlements and customary rates (UCR) a plus
- Strong negotiation, analytical, and problem solving skills; able to work well independently and in a team
- Excellent oral and written communication skills a must; able to work well under pressure and maintain a professional attitude
- Ability to prioritize work with tight schedules and target dates in a high volume environment required
- Detail oriented with demonstrated organizational skills; ability to multi-task and follow up
- Must meet performance standards including attendance and punctuality
- .
If you were eligible to this position, please email us your resume, with salary requirements and a resume to 1199SEIU Funds.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Fri, 1! 4 Feb 2014 18:05:39 GMT
Apply Balance Billing Coordinator II (Managed Care Health Claims) Here
Related Balance Billing Coordinator II (Managed Care Health Claims) Jobs in New York