Description
The Billing Coordinator (Generalist) is responsible for multiple components of the billing process, including Charge Entry, Edits, Payment Posting / Reconciliation, Accounts Receivable (denials and appeals). Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution.
Duties:
- Verifies insurance and registration data for scheduled office, outpatient, and inpatient encounters and scheduled surgeries; reviews encounter forms for accuracy. May be responsible for obtaining pre-certification for scheduled surgeries and admissions
- Enters office, inpatient, and/or outpatient charges with accurate data entry of codes. Ensures charges are entered/processed in accordance with policies and procedures
- May run workbench reports and communicate with appropriate parties for missing charges
- Posts payments / adjustments from paper EOBs and ERAs using approved methodologies with strong reconciliation skills.
- May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staff
- Works system edits and clearinghouse rejections. Proficient in moderate to complex encounters and problematic accounts
- Works daily Accounts Receivable accounts via online workfile and/or hard-copy reports; checks claim statuses, re-submits claims, edits, denials and process appeals which includes submit claim reconsiderations and writes appeal letters on a timely basis
- Researches unidentified / missing checks and communicate with appropriate parties for replacements
- Works credit balance report to ensure adherence to government regulations/guidelines
- Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendations
- Identifies and assists in resolves credentialing issues
- Meets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concerns
- Mentors less experienced Billing staff and assists Billing Manager/FPA Manager in training new staff
- May be responsible for collection of time-of-service payments, and maintaining daily transaction record of collected payments
- Maintains working knowledge and current in third party payer requirements
Requirements
- Associates Degree or high school diploma/GED plus 3 years of relevant experience
- CPC Preferred
- Trained in computerized medical billing
- 3 years’ experience in medical billing or health claims in a health care or insurance environment, and familiarity with ICD/CPT coding
BENEFITS
- Health Benefits: Medical, Vision and Dental
- 401k retirement plan
- Paid Time Off
