Billing Coordinator

Nema Health

1d•Remote

About The Position

Nema is seeking a full time coordinator to manage the day-to-day billing and revenue cycle management tasks for our growing business. The ideal candidate has extensive healthcare experience within healthcare billing and with payment practices. This person will act as a liaison between insurance companies, patients, and the Clinical Team to ensure accurate billing practices are executed with high quality.

Requirements

3+ years previous experience in medical billing and administrative roles interfacing with payers for functions such as eligibility verification and RCM
Proficiency in billing software and electronic health records (EHR) systems such as Silna, Candid and Healthie.
Strong understanding of insurance policies, procedures, and billing codes
Knowledge of third party payer reimbursement systems, rules and regulations relating to accounts receivable
Excellent attention to detail and accuracy in data entry and record-keeping
Sharp problem solving skills and ability to investigate and resolve discrepancies
Positive, solution oriented attitude and comfort with ambiguity as Nema builds billing processes
Effective communication skills, both written and verbal
Comfort and familiarity working with spreadsheets and analyzing data
Ability to work independently and manage time efficiently in a remote work environment
High level of integrity and commitment to maintaining patient confidentiality

Nice To Haves

VBC or alternative payment model claims billing experience related to telehealth services
Specific experience with CMS 1500 claims
Experience as a clinic or behavioral health facility billing specialist
Experience working remotely
Coding/Billing Certificate from an accredited institute or school preferred
Previous experience working in a healthtech startup
Passion for mental health and expanding access to treatment through insurance

Responsibilities

Submit for pre authorizations when needed, maintain a record of who needs a pre authorization, submit renewals, and track tasks
Prepare and submit insurance claims for services provided with accuracy to minimize delays in payment, while adhering to insurance regulations and guidelines
Monitor billing processes to ensure accuracy and completeness, identifying and rectifying any discrepancies or errors
Follow up on unpaid or denied claims, identifying reasons for denials and taking necessary steps to resolve issues. Improve on our billing system to minimize future claim denials
Process payments received from insurance companies and patients, accurately recording transactions and reconciling accounts
Collect outstanding patient responsibilities following claim adjudication. Issue past-due notices for accounts with outstanding balances
Maintain detailed records of billing activities, including claim submissions, payments, and denials. Generate reports as needed to track billing performance including monthly revenue reporting
Respond to inquiries from insurance companies, patients/families, and internal team members regarding billing and financial documents
Stay informed about changes in healthcare regulations and insurance policies to ensure compliance with billing procedures