Medical Billing Coordinator
2 weeks ago
Sterling Health Solutions, Inc.
Position: Medical Billing Coordinator
Supervision: Director of Revenue Cycle
Department: Finance
FLSA Status: Non-Exempt
Position Summary
The Medical Billing Coordinator is accountable for managing all aspects of medical, vision, and dental billing processes, as well as overseeing accounts receivable operations. This includes charge entry, payment processing, customer service, and follow-up, all while adhering to established protocols aimed at enhancing patient satisfaction and financial performance.
Key Responsibilities
- Accurately input all charges into the practice management system, ensuring that all charge batches balance in terms of the number of procedures and total amounts prior to posting.
- Post credit and debit adjustments to patient accounts in strict compliance with procedural guidelines.
- Organize and file all charge, payment, and adjustment batches by date for efficient reference.
- Review provider coding during charge entry to ensure adherence to Medicare standards and to facilitate timely reimbursement.
- Deliver exceptional customer service via phone and in-person for all patient inquiries regarding accounts, ensuring responses are provided within one business day.
- Verify patient demographic and insurance details at the time of charge entry to guarantee accuracy and prompt reimbursement.
- Conduct follow-ups on outstanding insurance claims at 60 days post-service, focusing on maximizing patient satisfaction and practice profitability.
- Manage follow-ups on patient account balances at 90 days post-service, utilizing aged accounts receivable reports.
- Provide relevant information regarding billing, coding, managed care networks, and insurance reimbursement to physicians and staff.
- Address returned claims, correspondence, denials, and account reconciliations within five working days to ensure maximum reimbursement.
- Submit primary and secondary insurance claims electronically on a daily basis to facilitate timely payments.
- Recommend accounts for external collection when internal efforts are unsuccessful, following established protocols.
- Process refunds to both insurance companies and patients in accordance with company policies.
- Monitor reimbursement rates from managed care networks and insurance carriers to ensure compliance with contractual agreements.
- Exhibit proficiency in all aspects of the medical, dental, or vision practice management system, including patient registration, charge entry, and advanced collections.
- Maintain organized records of coding, insurance carriers, and managed care networks for easy reference.
- Ensure a professional and efficient work environment, adhering to all practice policies related to OSHA, HIPAA, and Medicare compliance.
- Perform additional duties as assigned.
Knowledge, Skills, and Abilities
- Extensive knowledge of managed care networks and insurance carriers.
- Excellent written and verbal communication skills, along with strong customer service abilities.
- Thorough understanding of accounts receivable functions, including CPT and ICD-10 coding.
- Proficient in using PCs, the Internet, and MS Windows.
- Familiarity with medical, vision, and dental terminology.
Qualifications
- High school diploma or GED is required.
- Positive attitude with problem-solving skills and the ability to collaborate effectively.
- Self-motivated with the capacity to work independently.
Preferred Qualifications
- Associate's degree is preferred.
- Minimum of three years of accounts receivable experience, ideally in a Federally Qualified Health Center (FQHC).
- Experience with dental billing software is advantageous.
- Dental billing experience is preferred, with a willingness to learn.
- Certification as a Professional Coder (CPC) is preferred.
Special Requirements
Ability to perform a full range of motion, including manual dexterity and eye-hand coordination. This position requires sitting, standing, and walking for extended periods. The role may involve exposure to communicable diseases and other conditions typical of a clinical environment.
The information provided above outlines the primary responsibilities and qualifications for this position. It is not intended to be an exhaustive list of all duties and skills required. The organization reserves the right to modify job duties as necessary.
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