Clinical Operations Coordinator
1 month ago
The Clinical Operations Coordinator plays a vital role in ensuring the operational excellence of N.E.W. Community Clinic (NEWCC). This individual is responsible for managing the full array of services and programs provided by the organization to advance its mission and vision.
NEWCC has a unique mission of ensuring access for underserved, under-insured and uninsured patients regardless of the inability to pay.
The Clinical Operations Coordinator is responsible for ensuring accurate and timely billing of healthcare services, as well as following up on outstanding insurance claims and payor contracts.
This role involves interacting with patients, insurance companies and internal departments to ensure timely payment of claims, resolve billing issues and ensure a positive patient experience.
A personable demeanor, attention to detail, & patience is needed to ensure that the accounting department supports NEWCC in serving the uninsured and underserved in Brown County.
Key responsibilities include:
- Managing and processing insurance claims, ensuring accuracy and compliance with industry standards
- Reviewing and analyzing patient records to ensure accurate coding of procedures and diagnoses
- Monitoring and following up on outstanding claims to facilitate prompt reimbursement
- Contacting insurance companies to resolve billing issues, denials, and discrepancies; submitting appeals when necessary
- Collaborating and documenting processes and workflows to help streamline and create efficiencies to help with complex billing, coding, and payer issues
- Collecting cash receipts from clinics and ensuring funds are substantiated
- Working insurance claims denial management
- Verifying benefits for medical and behavioral health before patient is seen
- Gathering Medicaid wrap reports and sending to CFO
Qualifications include:
- High school diploma required, Associate's degree preferred
- Experience with EPIC/EPIC Wisdom preferred
- Experience with medical billing/insurance preferred
- Understanding of FAQH billing procedures and Sliding Fee schedules a plus
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