Coder I
Fresenius Medical Care
Summary
Ensure timely receipt of claim payments and minimization of unexpected bad debt by monitoring assigned denial work list, working with the appropriate clinical, regional and divisional staff to resolve any issues. Performs Accounts Receivable collection duties as assigned by Denials Supervisor, ensuring collection of past due balances to maintain profitability.
Job description
Purpose and Scope
Ensure timely receipt of claim payments and minimization of unexpected bad debt by monitoring assigned denial work list, working with the appropriate clinical, regional and divisional staff to resolve any issues. Performs Accounts Receivable collection duties as assigned by Denials Supervisor, ensuring collection of past due balances to maintain profitability.
Principal Duties and Responsibilities
- Monitors all work lists specific to the Denials Management Specialist Role.
- Ensures escalation of any work listed items requiring collaboration with other FKC partners (e.g., Managed Care, Master File Team, Coding, Non-Contracted, MFD).
- Identifies need for insurance changes and completes request for reverification process utilizing RIC coded comment.
- Initiates re-bill of unpaid or underpaid claims.
- Initiates appeal/reconsideration requests per payer guidelines.
- Transfer balance where applicable to correct responsible party.
- Process non cash related adjustments per established policy and procedure.
- Identifies and communicates improvement opportunities to denial management leadership to ensure timely and accurate payment.
- Ensure levels of follow-up are completed within established payer filing limits.
- Researches and identifies complex claims issues and discrepancies and escalates to supervisor for resolution as needed.
- Completes and documents all follow-up activities in eCube Financials per established guidelines.
- Assist with various projects as assigned by direct supervisor.
- Other duties as assigned.
Education
High School Diploma required
Experience and Required Skills
- 3 years healthcare billing or collections experience.
- Working knowledge of Windows-based software applications (i.e., Word, Excel)
- Excellent written and verbal communications skills.
- Good interpersonal skills and team oriented.
- Ability to work independently.
- Well organized and detail oriented.
Requirements
- High School Diploma required
- 3 years healthcare billing or collections experience
- Working knowledge of Windows-based software applications (i.e., Word, Excel)
- Excellent written and verbal communications skills
- Good interpersonal skills and team oriented
- Ability to work independently
- Well organized and detail oriented
Benefits
- Medical, Dental & Vision
- 401(k) Matching
- Paid Time Off
- Parental Leave
- Performance-Based Bonuses
Company overview
Fresenius Medical Care AG & Co. KGaA is the world's leading provider of products and services for individuals with renal diseases, serving as a global healthcare company specializing in kidney dialysis treatment. Founded in 1996 and headquartered in Bad Homburg, Germany with North American operations based in Waltham, Massachusetts, the company operates an extensive network of 4,171 outpatient dialysis centers across approximately 50 countries, serving over 345,000 dialysis patients worldwide. As the clear market leader in dialysis services, Fresenius Medical Care holds a dominant 38% market share of the dialysis market in the United States. The company provides comprehensive renal care solutions including hemodialysis machines, dialyzers, peritoneal dialysis solutions, and related medical devices through its 42 production sites globally. With approximately 128,000 employees, Fresenius Medical Care focuses on improving patients' quality of life through innovative technologies and therapies for end-stage renal disease treatment, offering both in-center and home dialysis options while maintaining a strong commitment to value-based care and patient well-being.