COORDINATOR, BILLING / FULL-TIME
Summary & Objective
Responsible for the billing and timely follow up of all claims for the physician practice in a cost effective and efficient manner. Successful accounts receivable management is predicated on ensuring that all demographic, insurance and financial information is gathered prior to treatment and is accurate.
The position is responsible for gathering data provided by the medical coders and compiling it to submit claims to healthcare insurance companies for payment. Responsibilities include billing patients for the balance that is not covered by the insurance payers.
- Verify and validate all insurance information provided to the physician practice.
- Use coded data to produce and submit claims (both electronically and manually) to insurance companies.
- Keep Manager informed of any and all issues that will impact the organizations cash flow.
- In coordination with the contracted billing company:
- Work directly with payers to forward all required information to them to ensure timely and accurate payment; this includes gathering all missing information to complete the claim for payment processing.
- Follow-up, in a timely manner on all accounts with outstanding balances and ensure that each account has all pertinent written and verbal communication documented in the system.
- Post all payments and EOBs to accounts receivable to ensure the accuracy and integrity of the accounts receivable.
- Follow and facilitate the successful resolution of all unpaid and denied claims. This includes submitting all required clinical and financial documentation as part of the formal appeal process.
- Prepare and process all private pay billing, incorporating balances that are not covered by the insurance companies.
- Contact patients in regards to all outstanding balances, coordinate payments or set up payment plans.
- Work with management to communicate with Physicians regarding issues (i.e.: coding) that impact billing and the ability to collect payments in a timely and accurate manner.
- Maintain your required license, certifications and mandatory skill updates.
- Comply with all policies, local, state and federal laws and regulations.
- Perform other duties as assigned.
- Must be able to lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds, walk, climb stair or ladders, stand on feet for extended periods of time, etc.
- Works in office environment with moderate to loud noise level.
- Subject to frequent interruptions.
- Work schedule may include working beyond typical schedule, including weekends and holidays.
- Hand dexterity required for data entry on keyboard, requiring finger dexterity and eye-hand coordination.
The job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.
CHS provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Knowledge & Experience Requirements
- High School diploma plus 2 years of experience in a physician office, processing billing and collections.
- Ability to research payer regulations and determine appropriate collection action
- Ability to calculate reimbursement per payer contracts
- Critical thinking skills and ability to communicate with others (i.e.: physicians, insurance carriers, patients, etc.)
- Must have knowledge of computer office/billing software
- Must be able to read, write and understand the English language