About The Position
The Billing and Reimbursement Coordinator serves as a leader in the billing area, manages accounts receivable, and acts as the department’s technical expert in their specialty area. The role oversees daily operations for assigned areas and supports accurate, compliant billing and reimbursement, including claims review, payer follow-up, quality monitoring, staff training, and coordination with other departments.
Requirements
- High school diploma or equivalent combination of education and experience.
- Technical and professional skills in medical or hospital billing, including insurance verification, benefit determination, medical terminology as it relates to billing, and understanding of the reimbursement cycle.
- Proficiency with computer functions, including automated systems for third-party billing and insurance follow-up.
- Ability to work efficiently and effectively under tight deadlines, interruptions, and high work volume.
- Thorough knowledge of HIPAA requirements related to job functions.
- Ability to work independently with minimal supervision.
- Good oral and written communication skills.
- Ability to manage multiple requests and projects simultaneously.
Nice To Haves
- Associate degree in accounting or business administration.
- One to two years of work experience in a health care setting.
- Certified Revenue Cycle Representative certification.
Responsibilities
- Manage accounts receivable for assigned areas while maintaining standards established by the director.
- Develop and maintain knowledge of hospital billing and reimbursement, and share information with or train staff.
- Maintain knowledge of compliance regulations, standards, and directives from governmental and regulatory agencies and third-party payers.
- Maintain billing and follow-up quality to support effective tracking and collection of reimbursement.
- Participate in interdepartmental projects, including provider onboarding, practice and provider education, coding review, and other special projects.
- Review claims daily for accuracy and required attachments using electronic billing software.
- Identify underpayments based on contract language and work with the contracting department.
- Maintain daily work queues according to payer requirements, including late charges and credits, multiple visits in one day, the 3-day rule, insurance coverage changes, claim errors, payer denials, and insurance follow-up.
- Perform quality reviews and analysis to support internal controls and monitor employee performance.
- Provide staff training, coaching, and support; identify and assess issues, resolve them, and keep the director informed of progress.
- Provide input into recruitment and corrective-action decisions, as well as performance evaluations.
- Oversee daily operations within the assigned department and meet management-established quality and productivity standards.
- Provide coverage and support for other teams.
- Work additional hours, including evenings or weekends, if needed to achieve team goals.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
