Billing Coordinator - CTI Pulmonology and Thoracic Surgery (hybrid)

Northwestern Memorial Healthcare • Chicago, IL

126d

About The Position

Performs charge capture for all procedures completed in the Bronchoscopy suite. This includes auditing CPT codes associated with each procedure, confirming supplies used and verifying alignment with operative notes. The role assists patients with billing and insurance related matters, including communicating with patients regarding balances owed and other financial issues, and facilitating collection of balances owed. The Billing Coordinator educates patients about financial assistance opportunities, insurance coverage, treatment costs, and clinic billing policies and procedures. They collaborate closely with physicians and technicians to understand treatment plans and determine costs associated with these plans, working closely with the staff on managed care and referral related issues, and communicating findings to patients. The position coordinates the pre-certification process with the clinical staff as it relates to procedures in the Bronchoscopy Suite and Operating Rooms, handles billing inquiries received via telephone or written correspondence, and is responsible for thoroughly investigating and understanding financial resources or programs that may be available to patients. The Billing Coordinator conducts precertification for appropriate tests or procedures and facilitates the process with managed care and the clinical team, documenting all information and authorization numbers in Epic and acting as a liaison for follow-up related to precertification. They perform activities and respond to patient inquiries related to billing follow-up, request necessary charge corrections, and identify patterns of billing errors, working collaboratively with the department manager and outside entities to improve processes as needed. The role provides guidance regarding clinical documentation to optimize charges and RVUs, confirms coding accuracy based on clinical documentation, and reviews common errors or misses with physicians and leadership. The Billing Coordinator reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards.

Requirements

• High school graduate or equivalent.
• Strong Computer knowledge, data entry skills in Microsoft Excel and Word.
• Thorough understanding of insurance billing procedures, ICD-10, and CPT coding.
• 3 years of physician office/medical billing experience.
• Ability to communicate clearly and effectively, both orally and in writing, at all levels within and outside the organization.
• Ability to work independently.

Nice To Haves

• 3 years of physician office/medical billing experience in Corporate Health/Occupational Health a plus.
• CPC (Certified Professional Coder) or R (Registered Medical Coder) Certificate a plus.

Responsibilities

• Ensures patient demographic and billing/insurance information is kept current in the computer application.
• Documents all patient and company contacts.
• Reviews daily clinic schedules and tracks receipt of documentation to assure completeness of charge capture.
• Ensures notes are placed in systems, clearly identifying steps taken, according to established procedures.
• Works with patients/clients to establish payment plans according to predetermined procedures.
• Handles all incoming customer service calls in a professional and efficient manner.
• Provides exceptional service to all customers, guarantors, patients, internal and external contacts.
• Prepares itemized bill upon request; explains charges, payments and adjustments.
• Produces a clear and understandable statement to individuals on any outstanding account balance.
• Responsible for timely submission of accurate bills and invoices to clients, patients and insurance companies.
• Ensures timely posting of all charges, payments, denials and write-offs to the appropriate account.
• Maintains the highest level of quality for each transaction processed within 48 hours of receipt.
• Responsible for balancing each payment and adjustment batch with reconciliation report and bank account deposits after completion.
• Ensures compliant follow up procedures are followed, to third party payers regarding outstanding accounts receivables.
• Runs outstanding A/R reports, follows-up on unpaid claims or balances with insurance companies, patients, and collection agency.
• Performs daily systematic review of accounts receivable to ensure all accounts ready to be worked are completed.
• Recommends accounts for contractual or administrative write-off and provides appropriate justification and documentation.
• Handles denials and appeals follow-up including root cause analysis to reduce/prevent future denials.
• Reviews, prepares and sends pre-collection letters as defined by department procedures.
• Identifies and sends accounts to outside collection agency.
• Prepares and distributes reports that are required by finance, accounting, and operations.
• Handles all work in an accurate and timely manner, consistently meets or exceeds productivity standards, quality standards, department goals and deadlines established by the team.
• Practices HIPAA privacy standards and ensures compliance with patient health information privacy practices.
• Identifies opportunities for process improvement and submits to management.
• Demonstrates proficient use of systems and execution of processes in all areas of responsibilities.

Benefits

• Tuition reimbursement
• Loan forgiveness
• 401(k) matching
• Lifecycle benefits

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees