Coordinator, EMR and Medical Billing

POWER•Pittsburgh, PA

6h•Hybrid

About The Position

POWER's mission is to help women reclaim their lives from addiction and related emotional health issues and improve the well-being of future generations. We are an agency committed to providing quality gender-responsive, trauma-informed treatment and recovery supportive services to women with substance use and co-occurring disorders. Job Summary: The Coordinator, EMR and Medical Billing is a key financial liaison between the fiscal services division and patient care operations, and is responsible for ensuring accurate, timely, and streamlined billing operations across the agency. This role will provide education, training, and communication on billing and revenue improvement measures, and operational efficiencies. Coordinate maintenance and upkeep of the Electronic Medical Record System (EMR). Perform and oversea the financial operations related to patient billing, insurance claims and revenue cycle management. This individual will ensure timely reimbursement, reduce outstanding balances, and maintain compliance with healthcare regulations. They will assure timeliness and accuracy of medical billing operations across the agency, manage insurance information within the EME, coordinate process and submission of billing and claims, and ensures compliance with all healthcare privacy regulations. The role will provide training and support to program staff on insurance eligibility processes, collaborate closely with fiscal, data analytics, clinical, and administrative teams, and assist with accounts receivable functions to reduce aging balances. The role includes resolving billing discrepancies, generating financial performance reports, and supporting continuous improvement of billing workflows. The role This is a key role in maintaining efficient revenue cycle operations and supporting the financial health of the organization.

Requirements

Bachelor's degree in healthcare or business administration preferred and/or equivalent 5 years relevant work experience.
Minimum of 5 years patient account experience required.
Proficient with Microsoft Office 365, including Word, Excel and Outlook. Proficiency with EMR systems.
Act 34, Act 33, and Act 73 clearances required
Ability to coordinate projects to meet the needs of users and establish priorities, make decisions and follow issues through resolution.
Excellent client service skills.
Excellent written and verbal communication skills.
Knowledge of basic patient accounting principles.
Familiarity with automated patient billing systems, medical terminology and coding.
In-depth knowledge of electronic data interchange and claims processing, third party payer rules, reimbursement practices and regulatory guidelines.

Responsibilities

Organize and Maintain EHR Records: Ensure all client insurance information is accurately entered, updated, and managed within the EHR system, including maintaining and updating the EHR billing matrix.
Process and Submit: Daily billing, insurance claims, client invoices, and insurance authorizations, ensuring accuracy, completeness, and compliance with payer requirements.
Train and Support: Train Administrative Coordinators and Intake Specialists on proper use of the Insurance Eligibility Verification system and provide support to ensure eligibility checks are completed accurately and in compliance with billing requirements.
Process and Submit: Daily billing, insurance claims, client invoices, and insurance authorizations, ensuring accuracy, completeness, and compliance with payer requirements. Determine and manage Single County Insurance requests and payments.
Accounts Receivable Collaboration: Work with the Fiscal Manager on accounts receivable processes and support strategies to reduce aging balances.
Resolve Billing Discrepancies: Investigate and resolve billing discrepancies while providing clear, timely responses to client and provider inquiries.
Collaborate Across Departments: Work with finance, Director of Data and Analytics, clinical, and administrative teams to streamline billing-related processes.
Prepare Performance Reports: Generate reports on collection performance, denial trends, and reimbursement metrics to inform financial decision-making.
Compliance with Healthcare Regulations: Follow HIPAA and other regulatory requirements to ensure the protection of client information, confidentiality, and privacy.
Other duties as assigned.