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Fairview Health Services Specialty Payer Coordinator in Minneapolis, Minnesota

Overview

The Specialty Payer Coordinator is responsible for managing all specialty payer claims. 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, outside vendors, and the Fairview Central Business Office to obtain the accurate reimbursement rates. This position also includes distribution of funds to all vested interests as applicable and allocation of funds to appropriate accounts. 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. Finally, this position may be responsible for representing Fairview to protect their interests in the form of hearings, settlements, and pretrials.

Responsibilities/Job Description

  • Responsible for applying transplant contract billing methodology to identified transplant patients

  • Coordination with Revenue Management, Financial Case Management, and outsourced partners to ensure proper billing and reimbursement for transplant patients

  • Coordination with the physician’s group, and other outside providers of service, to align billing functionality in accordance with our transplant contracts

  • Coordination of payments received, spread payments to appropriate accounts and write off any remaining balances once full settlement amount has been received. Close files when appropriate.

  • File claims appeals to payers to ensure proper reimbursement

  • Maintain an active list of contracted transplant patients, and share with vested parties

  • Printing appropriate bills for Fairview’s interest.

  • Request copy of Medical Records

  • Review medical records to determine if related to Fairview’s intervention interest match to appropriate bills to support Fairview’s intervention interest.

  • Assist in various special projects

Qualifications

  • Excellent computer and internet skills including at a minimum Word, Excel, PowerPoint

  • Knowledge of billing for healthcare

  • HS Dipoloma

  • Two or more years of experience in health care billing, preferably in transplant or another specialty

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Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Joined by HealthEast in June 2017, Fairview is one of the most comprehensive and geographically accessible systems in the state, with 12 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area and north-central Minnesota.

Its broad continuum also includes 56 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 network 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.

EEO/AA Employer/Vet/DisabledAll qualified applicants will receive consideration without regard to any lawfully protected status.

Requisition ID 2019-35580

Profession Non-Clinical Professional

Speciality Administrative/Clerical/Customer Service

Location Fairview offices at 400 Stinson

Shift day

Hours per 2 weeks 80

Department Transplant Financial Securing

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