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.
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 physicians 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 Fairviews interest.
Request copy of Medical Records
Review medical records to determine if related to Fairviews intervention interest match to appropriate bills to support Fairviews intervention interest.
Assist in various special projects
Excellent computer and internet skills including at a minimum Word, Excel, PowerPoint
Knowledge of billing for healthcare
Two or more years of experience in health care billing, preferably in transplant or another specialty
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 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.