The Billing Coordinator (Generalist) is responsible for multiple components of the billing process, including Accounts Receivable Follow Up, Edits, and Payment Posting. Proficient in these processes to facilitate accurate and timely payment of claims and collection.
Duties and Responsibilities
1. Verifies insurance and registration data for scheduled outpatient/inpatient encounters and scheduled surgeries; reviews encounter forms for accuracy. May be responsible for obtaining pre-certification for scheduled surgeries and admissions.
2. Enters office, inpatient, and/or outpatient charges with accurate data entry of codes. Ensures charges are entered/processed in accordance with policies and procedures.
3. May run and work missing charges, edits, denials list and process appeals. Posts denials in billing system on a timely basis.
4. Posts all payments using approved workflows.
5. May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staff.
6. Works Pre AR, Claim, and Payor electronic edits for all practices
7. Works Accounts Receivable via assigned workqueues including checking claim status, re-submit claims, and initiating appeals.
8. Researches unidentified checks sent to other departments.
9. Works credit balance report to ensure adherence to government regulations/guidelines.
10. Identifies billing issues and provides detailed information to management for resolution.
11. Identifies and assists in resolving credentialing issues .
12. Meets with CBO management to review Accounts Receivable and current billing concerns.
13. May be responsible to prepare and verify office hours schedules.
14. May be responsible for collection of time of service payments, and maintaining daily transaction record of collected payments.
15. May work Patient keeper work queue for inpatient encounters.
16. May approve EPIC work queue for all outpatient encounters.
17. May prepare TOS deposits in Sinai Central.
18. Maintains working knowledge and currency in third party payor requirements.
Associates Degree or high school diploma/GED plus 2 years of relevant experience
2 years experience in medical billing or health claims, with experience in IDX billing systems in a health care or insurance environment, and familiarity with ICD/CPT coding
Licensing and Certification Requirements
Certification: CPC preferred
MS Office Suite (please check one): (basic) (intermediate) (advanced)
Other: MS Office (Basic); training in computerized medical billing
General Skills and Competencies
1. Excellent organizational skills
2. Excellent communication and customer service skills
3. Knowledge of medical terminology and anatomy
4. Strong attention to detail and ability to multitask
5. Excellent calculation, verbal and communication skills
6. Strong ability in analysis and research
Describe Work Environment
General Office Environment