Job Description

Job Description

Reports to: LGBTQIA+ Practice Manager

Position Overview:

The Medical Billing coordinator manages all insurance verification, coding & charge capture, & oversight of the third-party billing on behalf of a busy LGBTQIA+ primary care practice. This role ensures accuracy & timeliness in all aspects of the revenue cycle management process.

Job Duties & Responsibilities:

• Manage patient billing and work with RCM vendors to conduct insurance verification, eligibility, & benefits before each medical visit and ensure all prior authorization is complete before delivery of ambulatory practice services
• Verify all insurance plans to ensure provider participation & insurance details
• Manage processes & workflows to ensure efficient & accurate billing and collections
• Confirm coding of billed services before submission to billing service or clearing house
• Post & track patient statements and payments
• Serve as a liaison to third-party billing service, including oversight of billed charges, denials, appeals, payments, and postings
• Monitor Availity & other billing software dashboards and review account receivables with the clinic, financial, and senior leaders
• Coordinate the practice's billing, reporting, and collection needs in conjunction with clinic staff, agency partners, and outside vendors
• Assists in retrieving provider encounter notes to support billing charges when needed
• Liaison with the third-party laboratory to ensure accurate account billing and payment
• Assists patients in understanding insurance benefits and patient financial responsibilities before services are rendered
• Ensure workflow and standard operating procedures are documented and maintained.
• Work with clinic leadership to identify areas of improvement
• Model a high level of service and professionalism for internal and external customers
• Other duties as assigned

Job Requirements & Qualifications:

• High School Diploma required; college education preferred.
• Two years of experience in insurance verification and billing in a comprehensive and specialty care environment
• Certification in coding and billing with experience in eClinicalWorks preferred
• Experience working with Medicare & Medicaid claims preferred
• Experience in ambulatory practice insurance verification, billing, and coding
• Proficiency in MS Word, Excel, Outlook
• Strong time management skills with attention to detail
• Excellent written and oral communication skills with technical and business acumen
• Knowledge of physician reimbursement, medical terminology, ICD-10, CPT, and HCPCS coding

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