The Specialty Payer Coordinator is responsible for managing High Dollar related denials. They must review, interpret, and apply problem solving skills to their daily work. This position includes coordination of information from the various departments within Fairview to obtain the specific information needed to resolve the High Dollar denial. This position requires attendance of various conferences and meetings on behalf of Fairview, either internally or externally, and knowledge of contractual and legal obligations pertaining to the position.
Basic understanding of Revenue Cycle, and the importance of evaluating all appropriate financial resources to assist in securing patient accounts to maximize reimbursement for the healthcare system Demonstrate billing and collection proficiency of multiple insurance payers Monitor accounts for timely follow-up and prompt resolution Communicate effectively with other departments Assist in continuous improvement of accounts receivable, while minimizing controllable loss categories, e.g., timely filing Stay informed of updates to regulatory changes Ability to locate and interpret payor policies Attend periodic meetings regarding various insurance payers to discuss denials, claims processing and other discrepancies, and assist in developing action plans to correct evaluated issues
Minimum Education: High School Diploma
Minimum Experience: Two years office, healthcare experience, preferably in a setting requiring specialty billing and handling
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider netwo...rk and health insurer PreferredOne. In partnership with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.