Medical Billing Coordinator

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 

• 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