Medical Billing Eligibility and Authorization Coordinator

San Diego Cardiac Center Medical Group Inc•San Diego, CA

4d•$21 - $23

About The Position

The Medical Billing Eligibility and Authorization Coordinator is an internal and external client-facing position within the Revenue Cycle. The role manages claims-related processes, including accurate and timely claim creation, follow-up, and correspondence with providers and insurers. The coordinator helps clarify and develop process improvements, responds to inquiries, and ensures payments for patient services from all sources are recorded and reconciled in a timely manner to maximize revenue. The role also supports credentialing, enrollment processing, and reporting for the San Diego Cardiac Center (SDCC). The position coordinates patient eligibility, referrals, and authorizations; maintains accurate patient demographic and insurance information; and supports patients, clinic staff, management, and insurance companies with related questions and issues. The coordinator works in a fast-paced, high-stress healthcare office environment and may travel between SDCC offices to provide support.

Responsibilities

Coordinate patient eligibility verification through various sources.
Work with reception staff to ensure appropriate collection of copayments, spend-down amounts, and self-pay fees.
Handle inquiries and answer questions from patients, clinic staff, and insurance companies.
Identify and resolve patient issues related to referrals, authorizations, and eligibility.
Handle eligibility denials with insurance companies and patients.
Communicate problems to the appropriate Supervisor or Manager.
Maintain strict confidentiality and adhere to HIPAA guidelines and regulations.
Answer management and coworker questions about eligibility, authorization, and referral procedures.
Obtain authorizations and referrals for office services in a timely manner.
Review appointment books before patient visits and verify eligibility with contracted insurance carriers.
Input and verify accurate patient demographic and insurance information.
Notify participating departments promptly when a patient's insurance is not contracted with the practice.
Respond to email and EHR messages and tasks in Epic throughout the day for all departments.
Serve as backup for team members handling eligibility, referrals, and authorizations.
Identify ways to assist fellow team members.
Represent SDCC, its staff, and providers professionally, courteously, and respectfully, on or off the property.
Perform other duties as assigned or requested.
Support the claims process through accurate and timely claim creation, follow-up, and correspondence.
Help clarify and develop process improvements and inquiries.
Ensure payments related to patient services are recorded and reconciled in a timely manner.
Support credentialing, enrollment processing, and reporting for SDCC.