Billing Coordinator-SECAP- 40hrs/week- Day Shift
Billing Coordinator, 40 hrs/week, Day Shift (Monday through Friday), No Weekends
I. Position Function:
Performs prior authorization and billing functions.
II. Job Relationships:
Reports to Director of Psychiatric Services
IV. A. Responsibilities/Essential Functions:
• Provides superior customer service to internal and external clients, customers, and patients as referenced in the Service Excellence Standards.
• Ensures that patients are appropriately registered. Corrects problematic registrations through admitting and/or billing areas. Requests assistance of clinicians and coordinator as needed.
• Ensures that services are pre-authorized as required by payers.
• Obtains pre-authorizations/approvals for outpatient and inpatient services as needed.
• Confirms ongoing authorization for treatment and obtains continuing authorization. If clinician involvement is required, informs clinician of necessary actions they must take.
• Enters charges electronically.
• Assures the final diagnoses and operative procedures as stated by the physician are valid and complete with the guidance of the system edits and reports.
• Obtains any necessary clarification of information on the notes and charts.
• Prepares the appropriate claims documents required by each insurer.
• Submits, organizes, and tracks all insurance claims filed by the health care provider.
• Follows up until payment is received and manages collections activities when necessary.
• In addition to administrative duties, required to perform a variety of customer service functions. These often include answering patient questions on billing and handling collections if a patient fails to meet his or her financial obligations.
• Maintains communication between clients, families, and internal departmental personnel to ensure exchange of information related to billing.
• Participates in ongoing improvement of billing and charge capture standards and procedures.
• Performs all charge follow-up such as edits, submission of supporting documents, and correction of codes, incorrect insurance, or incorrect demographics.
• Identifies denial patterns.
• Works in several billing and collections systems to reduce or correct denials.
• Collects copayments and outstanding balances.
• Utilizes all insurance verification systems.
• Orders all medical supplies and office supplies.
• Supports cross coverage for the front desk.
• Performs other duties as assigned to support departmental needs.
Minimum Education: High School diploma.
Minimum Experience: 2+ years of previous billing experience required.
Experience is health care setting strongly preferred.
Minimum skills/abilities: Computer software competencies (MSWord suite, ability to quickly learn scheduling and charge entry systems). Good organizational skills. Ability to return to tasks and follow-up on issues requiring multiple interventions.
Certification/Licensure: Billing and coding certificate preferred.
Training: Experience as above