The Billing Coordinator is responsible for researching and resolving coding, professional fee claims, and claims edits or denials using a variety of proprietary and external tools while maintaining strict compliance with all applicable guidelines.
Major Position Responsibilities:
- Performs all functions necessary to implement and coordinate effective billing compliance plan for PCP as it relates to billing and charge master maintenance.
- Works closely with billing partner on issues which prevent claims from final billing (i.e. verification and authorization, Medical Record Request/Delays).
- Set up and maintain all components of revenue cycle process for PCP clinic.
- Ensures that billing and charge master comply with regulatory agencies and Medical Center procedures in charge practice/definition and coding.
- Determines the appropriate level of care charge on all patient accounts.
- Reviews billing prior to submission to corporate office.
- Checks all accounts for accuracy and correct charges.
- Uses computer for researching, changing data (i.e. addresses, financial/insurance codes, etc.) and entering PA notes.
- Respond to patient account inquiries.
- Performs other duties as directed.
Safety and Infection Control Responsibilities
- Responsible to maintain a safe and clean work environment, including unit based specific safety and infection control requirements.
Qualifications: ESSENTIAL COMPETENCIES, KNOWLEDGE, & EXPERIENCE
- Typing 50 wpm accurately; filing skills.
- Experience in billing, contracts & collections, required.
- Ability to communicate effectively utilizing both written and verbal skills, required.
- Knowledge of medical terminology and surgical procedures.
- Possesses strong organizational skills and prioritizes getting the right things done.
- Demonstrated knowledge of computer technology, including word processing, spreadsheet, and database.
- Highly developed interpersonal skills in order to relate to all personality types in dealing with physicians, staff, and patients.
- High School diploma or GED required.
- Medical coding education preferred.
- Certified Professional Coder (CPC), preferred.
Each new hire candidate who is offered employment must pass a physical evaluation, urine drug screen and pre-employment background checks before starting work.