Billing Coordinator - CAIPA MSO LLC : Job Details

The Billing Coordinator (Generalist) is responsible for multiple components of the billing process, including Charge Entry, Edits, Payment Posting / Reconciliation, Accounts Receivable (denials and appeals). Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution.

Duties:

• Verifies insurance and registration data for scheduled office, outpatient, and inpatient encounters and scheduled surgeries; reviews encounter forms for accuracy. May be responsible for obtaining pre-certification for scheduled surgeries and admissions

• Enters office, inpatient, and/or outpatient charges with accurate data entry of codes. Ensures charges are entered/processed in accordance with policies and procedures

• May run workbench reports and communicate with appropriate parties for missing charges

• Posts payments / adjustments from paper EOBs and ERAs using approved methodologies with strong reconciliation skills.

• May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staff

• Works system edits and clearinghouse rejections. Proficient in moderate to complex encounters and problematic accounts

• Works daily Accounts Receivable accounts via online workfile and/or hard-copy reports; checks claim statuses, re-submits claims, edits, denials and process appeals which includes submit claim reconsiderations and writes appeal letters on a timely basis

• Researches unidentified / missing checks and communicate with appropriate parties for replacements

• Works credit balance report to ensure adherence to government regulations/guidelines

• Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendations

• Identifies and assists in resolves credentialing issues

• Meets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concerns

• Mentors less experienced Billing staff and assists Billing Manager/FPA Manager in training new staff

• May be responsible for collection of time-of-service payments, and maintaining daily transaction record of collected payments

• Maintains working knowledge and current in third party payer requirements

• Associates Degree or high school diploma/GED plus 3 years of relevant experience
• CPC Preferred
• Trained in computerized medical billing
• 3 years' experience in medical billing or health claims in a health care or insurance environment, and familiarity with ICD/CPT coding

Benefits

• Health Benefits: Medical, Vision and Dental
• 401k retirement plan
• Paid Time Off
• Hybrid Work Model

Salary Range:

• 40k-60k

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