Billing Coordinator

Position Title: Billing Coordinator

Department: Billing

Reports To: Billing Manager

Position Summary

This position manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries/correspondence. The incumbent will assist in the clarification and development of process improvements and inquiries, assure payments related to patient services from all sources are recorded and reconciled timely in order to maximize revenues. Other important duties include credentialing, enrollment processing, and reporting.

Qualifications

High School diploma or equivalent required. At least 2 years relevant medical billing experience. Medical Billing and Coding Certifications preferred.

Essential Functions & Responsibilities

1. Prepare and submit clean claims to insurance payers either electronically or by paper.
2. Fix any outstanding claims in Waystar on a daily basis.
3. Maintain relationship with clearinghouse, including appropriate follow-up with support issues.
4. Coordinate the process of patient eligibility through various third-party sources.
5. Coordinate collection with GLA collection agency.
6. Manage monthly statement process, to include reviewing statements before mailing and field any patient inquiries the Patient Services staff needs to escalate.
7. Work with front office staff supervisors, to ensure appropriate collection of co-pay and self pay fees.
8. Handle patient inquiries and answers questions from clerical staff and insurance companies.
9. Identify and resolve patient billing problems. Denial and insurance follow-up management.
10. Make adjustments, correct, and/or rebill claims to third party payers.
11. Post adjustments, transfer of responsibility and refunds, as necessary.
12. Assure coding is compliant and up to date.
13. Review accounts and make recommendations to the Billing Office Manager regarding non collectible accounts.
14. Maintain strict confidentiality; adheres to all HIPAA guidelines/regulations.
15. Credentialing – Maintain up-to-date credentials for each licensed provider, including verification through primary and secondary sources, records, and relay credentialing information

to relevant personnel as needed. Keeps accurate records of provider licensure/ certification renewals. Coordinate provider enrollments in all commercial, state and federal insurance programs. Correspond with and provide updates to insurances.

16. Utilizes monthly aging reports for follow-up work and filing appeals when appropriate to obtain maximum reimbursement and reports results to Billing Office Manager on a monthly basis.

Mandatory Requirements

1. Adhere to Astra Behavioral Health policies and procedures.
2. Attend mandatory in services and other training/educational programs as required.

Qualifications

High School diploma or equivalent required. At least 2 years relevant medical billing experience. Medical Billing and Coding Certifications preferred.