The Account Coordinator’s primary responsibility is monitoring operational activities associated with referrals and reviews for an assigned book of accounts. This includes product and process education of clients, soliciting additional claim information from clients, providing relevant updates to clients and internal teams, tasks associated with preparing and validating data for billing, trouble-shooting and contributing to continuous process improvement efforts
Coordination of Claim Activity
Build and maintain operational relationships with clients to ensure customer satisfaction
Understand claim flow and work closely with operations personnel to determine additional information requirements essential to the Forensic Review or Appeal. Per client/claim handling instructions, contact client as appropriate to obtain data. This can include follow-up with facilities to obtain information needed to process claims.
Establish and maintain contact (verbal and written) with customers, third parties and Sales from the referral submission through case closure per client/claim handling instructions and service standards; present agreed upon regular status updates
Assist clients with claims submission, including handling and researching rush requests and verify pertinent information is provided to ensure efficient and timely handling for review process
Procure claims payment information (EOPs) from clients in a timely fashion.
Prepare and distribute accurate client status reports per the established schedule. Present key outstanding issues and operational challenges through the intake and review process.
Responsible for processes required for billing Equian work including validation through client systems, communications with Finance and accuracy and timeliness of invoicing.
Facilitate conference calls for clients as needed for updates and discussions
Contribute to development of innovative, practical solutions to solve client problems
Understand client requirements and clearly and quickly communicate issues
Education and Certifications
Bachelor’s degree highly desirable
3+ years of progressive business experience in a health care or insurance environment
Experience in client-facing service position
Knowledge of insurance terminology
Excellent verbal and written communication skills
Strong organizational skills and attention to detail including financial information
Ability to multi-task and work with little direction
Ability to handle delicate matters with diplomacy
Flexible and adaptable to a growing and changing environment
Advanced computer skills, including Word and Excel