Billing Coordinator

Handles third-party insurance billing, reviews medical information for accurate claims, collaborates with coders, and addresses denials, errors, and recurring issues to ensure proper reimbursement.

Essential Functions

• Prepare, process, and submit clean claims to insurance payers according to guidelines and deadlines, electronically or by paper.
• Gain knowledge of dental billing within the dental billing platform.
• Gain knowledge of pharmacy billing processes.
• Gain knowledge of Honor Every Woman program.
• Gain knowledge of Worker’s Compensation/Attorney claims.
• Maintain current knowledge of each payer’s rules, regulations, and deadlines and apply that knowledge in daily work.
• Recognize and identify errors and communicate them to Billing Coordinator II or III.
• Monitor and reconcile delinquent accounts.
• Prioritize workload and meet quality and production standards.
• Communicate with clearinghouse and insurance companies regarding claim status, rejections, denials, corrections, and related issues.
• Communicate with the coding department regarding coding-related denials needing correction.
• Provide third-party account status and issues to the Lead Biller or Business Office Manager.
• Perform daily clearinghouse reconciliation of reports and claims.
• Answer questions from patients, clerical staff, tribes, subcontractors, and insurance companies.
• Perform collection actions including contacting payers by phone, correcting claims, and resubmitting claims.
• Participate in CMS, IHS, and private insurer educational activities as needed.
• Maintain strict confidentiality and follow HIPAA regulations.
• Perform other related duties as assigned.