TITLE Business Office Coordinator
CLASSIFICATION NUMBER 6160
IMMEDIATE SUPERVISOR Associate Director, Taylor Health and Wellness Center
MAJOR ADMINISTRATOR Director, Health and Wellness Services
The Business Office Coordinator processes billing of Taylor Health and Wellness Center charges, processes payments to patient accounts, and answers patients’ questions about their accounts. The Business Office Coordinator assures medical procedures are properly coded to maximize reimbursement for the patient and the Health Center, reviews the usage of International Statistical Classification of Diseases and Related Health Problems (ICD-9) and Current Procedural Terminology (CPT) codes for appropriateness, audits Explanations of Benefits (EOB), posts payments to accounts, and researches errors and non-payments.
MINIMUM ACCEPTABLE QUALIFICATIONS
Education: A high school education is required; a Bachelor’s degree in Accounting or Business Administration is preferred.
Experience: At least five years of experience processing medical insurance claims and/or billing and posting payments to patient accounts is required. Experience working with patient accounts in an automated environment is required.
Skills: Must have an up-to-date understanding of current health insurance practices and trends; must have an understanding of bookkeeping practices related to patient accounts. A current understanding of the Health Insurance Portability and Accountability Act (HIPAA) regulations and their application relative to patient medical records and charges is required.
ESSENTIAL DUTIES AND RESPONSIBILITIES
1. Helps to assure proper handling of cash at the Health Center by overseeing and monitoring the daily deposit reconciliation and auditing of cash transactions.
2. Helps to assure maximum reimbursement for patients and the Health Center by assuring proper coding of medical procedures, coordinating with medical staff to properly utilize ICD-9 codes relative to the severity of the illness, the level of intensity of service, and the proper procedure, auditing the EOBs to identify errors and nonpayments, obtaining additional information, and resubmitting claims.
3. Provides excellent customer service by answering questions about patient accounts and making any adjustments or corrections promptly.
4. Assures patient privacy is maintained by being knowledgeable and following HIPAA regulations and releasing patient medical information in accordance with HIPAA and University policy.
5. Anticipates the effect of changes in patients’ insurance coverage by advising medical staff of the possible effects on diagnosis and procedure coding.
6. Helps to assures continuity of care for patients by coordinating the business office part of the process of patient referrals to specialists.
7. Helps to ensure the most seamless processing of billing for Medicare patients by processing Medicare claims and coordinating Medicare crossover to the secondary insurance.
8. Assists the pharmacy in correcting patient accounts following errors in the initial claim submission.
9. Helps to ensure an audit trail by maintaining accurate and complete files of adjustments and corrections.
10. Assists students and their parents by providing information about the coverage of the student insurance plan.
11. Remains competent and current through self-directed professional reading, developing professional contacts with colleagues, attending professional development courses, and attending training and/or courses required by the Associate Director, Taylor Health and Wellness Center.
12. Contributes to the overall success of Taylor Health and Wellness Center by performing other duties as assigned.
The Business Office Coordinator is supervised by the Associate Director, Taylor Health and Wellness Center and supervises full-time and part-time employees and student workers.
OFFICE OF HUMAN RESOURCES
REVISED MAY 2013
JOB FAMILY 1
Factor 1: Educational/Experience Requirements of the Job
Level 6 - 900 Points: A combination of education and experience equivalent to a Level 6 as indicated by the Equivalencies Chart, when permitted by the Minimum Acceptable Qualifications.
Factor 2: Complexity and Technical Mastery
Level 4 - 370 Points: In addition to considerable skill in oral and written communication, the ability to make basic mathematical calculations, the ability to understand and follow instructions, knowledge of moderately complex or other work procedures, and the ability to work independently and coordinate a variety of activities and events, the job requires specific professional skills and/or skills in managing a wide variety of complex processes.
Factor 3: Responsibility for the Work of Others
Level 4 - 110 Points: Some supervision and training of small numbers of student or part-time workers is required where the nature of supervision is largely confined to scheduling work and assigning tasks. Supervision at this level may also involve directing the work assignments of one or more permanent, full-time employees. Supervisory tasks may include providing input into hiring and employee evaluation processes, but the final decisions are made by other supervisors. The incumbent typically does not perform a full range of supervisory responsibilities, and supervisory duties typically involve relatively little time during the work day.
Factor 4: Guidelines
Level 3 - 220 Points: The work involves carrying out a group of procedures using the general methods and desired results indicated by the supervisor. Typically, standard operating procedures, handbooks, and/or reference manuals exist for most procedures, but the incumbent must select from the most appropriate of several guidelines, and make minor adjustments to methods. The incumbent uses judgment in interpreting and adapting guidelines such as University policies, regulations, precedents, and work directions for application to specific cases or problems. The incumbent makes decisions regarding most deviations from the guidelines but major deviations from guidelines are referred to the supervisor. Assignments are related in function and objective, but processes, procedures, or software varies from one assignment to another. Based on assignment, incumbents use diverse but conventional methods, techniques, or approaches. Jobs at this level may perform work that is moderately complex, but normally performed within a fairly narrow and specific functional area.
Factor 5: Contacts
Level 4 - 205 Points: The purpose of interactions is to solve recurring and structured problems, to provide specialized or technically precise information to others, and/or to plan or coordinate work efforts with other employees. Contacts involve cooperation and coordination and may involve the organization of activities of programs requiring working relationships among several parties. While contacts may require some level of persuasion, potential for conflicts and disputes are relatively minor. Interactions are moderately structured and routine and may involve employees in different functions, students, and/or the general public.
Factor 6: Work Impact
Level 4 - 475 Points: Work activities normally address conventional problems or situations with established methods to supply other employees with information, services, or products they use to perform their work. Work products or services facilitate the work of other employees and directly affects the ability of other employees to timely complete specific tasks or processes. Work activities may affect the quality of services provided to moderate numbers of employees, students, or the public, and the services, information, or products provided have significant effects on the welfare of the affected groups.
Factor 7: Physical Effort and Work Environment
Level 1 - 25 Points: The work environment consists of exposure to physical conditions typical of a normal office environment. Most of the job is performed while sitting, although the work may require occasional standing or walking and/or the lifting and carrying of small objects.