Description SUMMARY: The Billing Coordinator works as an integral part of the Finance Team. The Billing Coordinator will perform, but is not limited to, the following duties: will be responsible for obtaining accurate demographics to support claims, timely and accurate submission of claims and reports, benefit and eligibility verification as well as resolutions of denied claims. This position may require a flexible schedule including 1st and 2nd shifts. The agency has the right to change shifts based on the needs of the organization. ESSENTIAL FUNCTIONS: Position Specific Duties
- Files claims with all appropriate payers.
- Generates billing reports that reflect payer summaries of claims filed and amounts collected.
- Transmits billing electronically and manually for all companies in accordance to departmental deadlines.
- Performs timely and accurate applications and insurance company payments/adjustments.
- Evaluates denials in a timely manner for appropriate reconciliation, rebilling and other necessary follow up.
- Reviews and utilizes Accounts Receivables aging and billing error reports for the purposes of correction, reconciliation and problem resolution
- Receives phone calls and inquiries from both third party payers and individuals served on claims and responds to inquiries.
- Maintains and updates financial files that contain current demographics, historical data, financial status and payer source.
- Works cooperatively with other departments to obtain accurate clinical and demographic information to ensure timely billing and collection of fees owed for services rendered.
- Works with staff on third party verification to assure proper pre-certifications are obtained from insurance companies.
- Performs insurance verifications when necessary.
- Assist the Agency's Finance Department by performing accounting and related functions including but not limited to: accounts receivable and payable, 3rd party billing and tabulation, bank deposits, reconciliations, etc.
- Observe and identify consumer concerns relating to payment requirements.
- Ability to climb three flights of stairs to deal with emergencies.
- Ability to respond to emergency situations by placing calls to Fire, Rescue, Police, and Medical etc.
Administrative Tasks:
- Complete all required documentation in a timely manner.
- Perform program recordkeeping and filing, and organize vital documents.
- Provide telephone coverage for the assigned program and direct calls to other programs as needed.
- Participate in required supervisions, staff meetings and trainings.
- Participate and cooperate in any investigations conducted by internal and external agencies.
- Ability to use a computer including inputting information into the electronic health record.
Compliance Requirements:
- Remain awake during your shift at all times.
- Attend all mandatory trainings and update all licenses and certifications.
- Adhere to program/project/department requirements and services.
- Follow all reporting guidelines by deadlines including the completion of a Confidential Incident Report.
TITLE: Billing Coordinator REPORTS TO: Director of Billing CLASSIFICATION: Exempt SHIFT: 1st, 2nd DIVISION: Administration REVISED: September, 2020 QUALIFICATION REQUIREMENTS: The Billing Coordinator must perform each essential function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. The qualifications listed below are representative of the knowledge/skill and/or ability required.
- Associate degree in business management preferred.
- Minimum of three years of experience in billing Managed Care Organizations/third party billing required.
- Superior attention to detail, organizational skills, analytical skills, computer skills and multi-tasking skills.
- Good working knowledge of computers, electronic health records and data collection.
- Requires valid driver's license due to business-related travel.
WORK ENVIRONMENT REQUIREMENTS: The work environment requirements are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.
- The work noise level is that of an average busy home.
- Ensure safety through fire drills and emergency evacuations.
- Ensure a safe workplace to reduce potential risk of violence.
- Ensure a safe and clean program addressing and communicating any facility issues.
- Observe all health and safety requirements including Tuberculosis (TB) screening.
- Abide by the Hazard Communication policy and the disposal of hazardous waste.
- Abide by the Bloodbourne Pathogens/Universal Precautions policy and procedure.
- Adhere to all emergency evacuation procedures.
PHYSICAL REQUIREMENTS: The physical requirements are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Requires good vision (the ability to see) either with or without various assistive devices.
- Requires the ability to hear either with or without various assistive devices.
- Requires the ability to communicate information effectively to others both verbally and in writing.
- Some manual dexterity is required in carrying out applicable aspects of position responsibilities.
- Some manipulative ability is required in carrying out applicable aspects of position responsibilities.
- Position requires overall light physical effort.
- Frequent climbing of stairs is required in carrying out applicable aspects of position responsibilities.
- Ability to quickly move throughout the facility in carrying out applicable aspects of position responsibilities
- Ability to quickly perform emergency-type actions as needed (Police, Fire, Medical, etc.)
ACKNOWLEDGEMENT I have read this position description and understand my responsibilities and the knowledge, skill and/or ability required to satisfactorily perform the essential functions. I understand from time to time I may be required to perform job functions that are not included in this position description. I will abide by all guidelines in the Policy & Procedure Manual. I will abide by the current Employment Handbook including but not limited to:
Abide by ethical standards and professional boundaries at all times. Abide by the confidentiality regulations concerning consumers and all agency proprietary information. Adhere to the social media and internet policies. Abide by the Harassment policy. Comply with the drug-free/alcohol-free workplace policy. Adhere to the no smoking policy at all times-- on the premises, in any building or agency vehicle.