Patient Accounts Coordinator – Lead- (REMOTE) Full Time

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Luminis Health
April 1, 2022
Lanham, Maryland
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Patient Accounts Coordinator – Lead- (REMOTE) Full Time/ 9am-5:30pm

Job #: TPC-76468
Category: Finance
Facility: Luminis Health
Location: Lanham, MD
Posted Date: March 29, 2022






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Position Objective: 

Responsible for accurate and timely preparation and submission of correct claims to third party carriers and intermediaries. Ensures immediate payment is made to the hospital to provide a positive cash flow. The Coordinator of Lead Patient Accounts is responsible for scheduling and assigning work of patient accounts coordinators as well as training and coaching new employees, to maintain expertise in producing an accurate bill. This position is also responsible for daily functions as the Coordinator, Patient Accounts.

Essential Job Duties:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.  Answer phone. Identifies and acknowledges customer's needs.

  • To provide service excellence within three rings, answers any/all ringing phones.
  • Use proper phone etiquette. Limit 'on hold' time. Be a good listener.
  • Document activity in note posting function of computer for record keeping

2.  File and document as needed to provide a record of activity.

  • File payment schedules for easy retrieval for payment verification and secondary billing.
  • Document all activity in note posting to provide an accurate trail for use in collecting and final resolution of the account.

3.  Follow emergency procedures.

  • Know emergency codes and respond immediately to those applicable to Patient Accounting Department.
  • Follow documented policies and procedures for personnel in fire, internal disaster and bomb threat emergencies

.4.  Generate, process and submit claims to third payers, intermediator and patients for payment.

  •  Preparation of claims must include all criteria required by the payors.
  • On a daily basis produces bills of high quality. Reviews each UB92 for complete and accurate information. Ensures the reasonableness of changes. Request required attachments for billing from Health Information Services.
  • Complete and mail clean, accurate claim forms and/or input billing data via terminal and/or edit downloaded claims in windows of the personal computer for all accounts received that day. Bill inpatient, day surgery and outpatient accounts in that order so higher dollar amounts are billed first.
  • Input information into the CRT to reflect daily activity done on the patient's account to use if follow-up is necessary. Accurately note patient's account with correct billing information, billing date, and billing address.
  • Late charge billing – As necessary, prepares an adjusted late charge bill to ensure late charges are appropriately billed or adjusted off accounts.
  • Secondary billing – As necessary, all secondary insurance's are to be billed when the remittance advice or notification is received from the primary carrier.
  • Interim billing – Complete as necessary, first. Obtain coding for the working diagnosis and procedures that have been performed during the billing period.
  • Audits – As necessary after the audit is finalized, the adjustments are submitted to the biller for rebilling. 9. Over – undercharges – The biller issues a refund promptly. If under billed, the biller will re-bill.

5.   Maintain confidentiality of patient information.

  • Maintain confidentiality of patient information and discuss patient's medical record and bill only with authorized individuals and with those involved in the care of the patient.

6.   Perform pre-billing review to ensure accurate information is obtained to produce an accurate bill.

  •  Review the patient verification forms for benefits to provide necessary billing elements to complete the form correctly.
  • Verify all demographic and financial data so it is correctly coded in the computer system to produce an accurate UB92 form.
  • Review and compute patient cost share and put it under the patient's responsibility in the computer system, in order to collect any balance due from the patient when the very first bill is sent to the patient

7.   Resolve return mail to determine if an account is collectable or should be referred to a collection agency.

  • Within three (3) days of receipt research and resolve returned mail to assure the bill was sent to correct payors. Document activity in note posting function of computer for record keeping.

8.  Respond to inquiries received via correspondence

  • To limit days the account is in receivables, within three days of receipt, answers questions from: Insurance companies, (Medicare, Blue Cross/Blue Shield, Medicaid and all other third party payors), patients, hospital employees, attorneys, and collection agencies.
  • Document activity in note posting function of computer for record keeping.

9.   Review and follow-up on outstanding accounts.

  • Each account is to be reviewed and a follow-up performed at the appropriate time for an effective accounts receivable program. The biller initiates the follow-up on new accounts at time of billing. A follow-up date of 21 days is keyed in the system and/or noted on the tickler file.
  • Contacts insurance companies to expedite prompt and accurate payment of hospital claims, using effective collection tools, collection calls, letters, etc. Get assurance that all the necessary forms have been provided by the hospital to pay the claim. If not, the billing will need to be repeated.
  • Input information into the CRT to reflect daily collection activity.
  • When an effort has been made to collect from the patient as well as the insurance carrier and no response is received in a timely manner, the account is referred to the collections department or a collection company for more aggressive collection procedures.

10. To bring accounts to an end, resolve credit balances.

  • Research and resolve credit balance created by overpayments from insurance companies and patients. Also resolve monies placed on the wrong accounts and unidentified payments.
  • Prepare check requests and provide payment back-up for administrative approval.
  • Document activity in note posting function of computer for record keeping.

11.  To ensure proper and accurate payments are made on accounts, audits payments rejections/schedules.

  • To ensure proper balances are on the account, on a daily basis reviews daily payment listing and third party schedules.
  • Audit payments for correctness in relationship to verification. Verifies rejections for validity, appealing when necessary.
  • Work schedules and make adjustments and discounts as appropriate.
  • Document activity in note posting function of computer for record keeping.

12.  Train and develop team members as needed to keep work product accurate.

  • Training new members as needed to keep work product accurate: Use on-line automated computer system using CRT. Use personal computers-window functions used for electronic billing. Use CRTs installed by third party payors. Understand UB92 billing procedures. Perform pre-billing activities. Perform billing and collections activities. Review all problem bills and resolve problems. Respond to inquiries, answer phones. Audit payments, rejections, schedules. Resolve credit balances. Adjust patient accounts. Resolve return mail. Document.
  • Coordinate on-going training for entire team, hold in-house training sessions. Keep team members up-to-date on changes affecting billing and collecting procedures. As needed for optimum productivity: Coordinate work schedules of team. Distribute workload of team. Monitor and control rejections and error rate of team. Assist in handling of insurance inquiries from insurance carriers, keeping them for reference. Assist in resolving customer complaints.
  • Monitor and maintain insurance master file so as to execute claims in a timely manner. Determine what is required for each payer in the spectrum of payers used by the hospital. Follow outline guidelines in the UB92 procedure manual to complete uniform bill needed for billing. Know glossary of terms provided and used in UB92 procedure manual. Determine what requirement constitutes a clean claim and ultimately a paid bill. Attends special workshops or training sessions for our third party payers and intermediaries to maintain current knowledge relative to billing and collecting procedures.

Educational/Experience Requirements:

Required Minimum Education: 

  • High School Diploma or GED

Required Minimum Experience:

  • Knowledge of Third Party payors and intermediaries billing requirements.
  • Medical Terminology required.
  • One year of college and one year computer training preferred. Strong Business Math, technical expertise.
  • Two years experience in a health organization insurance billing and collections environment including one year working an online, automated billing and collecting system.

Required License/Certifications:

  • N/A

Knowledge, Skills, Abilities:

  • Minimum typing 40 wpm.
  • Understanding of Maryland Health Cost and Review Commission billing guidelines.
  • Understanding of UB92 regulations and importance, block locators, form and input knowledge

Working Conditions, Equipment, Physical Demands:

There is reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

  • Concentrates on moderate to fine detail for extended periods of time.
  • Must be able to hear normal sounds with some background noise.
  • Remembers schedules, tasks to be completed, where activities left off, etc.
  • Routinely lifts objects under 20 pounds.

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.


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