About this role
Billing Coordinator I
Full-Time (Hybrid)
ESSENTIAL DUTIES
- Review governmental and non-governmental payer claims for accuracy and ensure billing charges comply with payer-specific guidelines.
- Work daily unbilled charge reports to identify discrepancies, process charges, and submit claims according to established processes and workaids.
- Monitor and resolve claim production red edit reports daily, to clear edit, coordinate with health center staff for corrections and ensure timely claim submission.
- Review and resolve rejected claims queues in the clearinghouse to transmit claims per workaids and expectation set by department.
- As assigned, respond to billing-related inquiries from health center staff to expand knowledge of issues and resolutions methods.
- Process incoming correspondence for the assigned health centers, including payer notifications, returned claims and take appropriate action to resolve and rebill to the corrected claim.
- May need to report onsite when required and perform additional duties and special projects, if closer to the administrative office.
- Must meet department’s productivity and claim submission benchmarks and billing Key Performance Indicators (KPIs) and benchmarks.
- Adhere to departmental policies, procedures, billing guidelines, productivity expectations, and established timelines.
- Maintain confidentiality of patient and organizational information in accordance with HIPAA regulations.
- For remote work arrangements, maintain a secure, organized, and HIPAA-compliant work environment that supports productivity and protects confidential information.
- Perform other duties and special projects as assigned
Non- Essential Duties:
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Serve as backup for other employees for breaks and absences as needed
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Perform other duties as assigned
Qualifications
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High School Diploma required
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Knowledge of professional claims billing or one to two years of experience in medical billing.
- Ability to manage multiple tasks/projects simultaneously and adapt to frequent priority changes
- Good writing, editing and communication skills with attention to detail and accuracy
- Knowledge of Medi-Cal, State Programs & Commercial Insurance (HMO, PPO, EPO, etc) preferred
- Basic proficiency in Microsoft Word and Excel
- Must adhere to all HIPPA guidelines and regulations and maintain patient and organization confidentiality.
- Must follow affiliate policies and procedures
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