Billing Coordinator

Role Description

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.

Responsibilities

• Pre Authorization Management:
  • Submit for pre authorizations when needed
  • Maintain a record of who needs a pre authorization
  • Submit renewals and track tasks
• Claims Submission:
  • Prepare and submit insurance claims for services provided with accuracy
  • Minimize delays in payment while adhering to insurance regulations and guidelines
• Billing Management:
  • Monitor billing processes to ensure accuracy and completeness
  • Identify and rectify any discrepancies or errors
• Claim Follow-Up:
  • Follow up on unpaid or denied claims
  • Identify reasons for denials and take necessary steps to resolve issues
  • Improve on our billing system to minimize future claim denials
• Payment Processing:
  • Process payments received from insurance companies and patients
  • Accurately record transactions and reconcile accounts
• Collecting:
  • Collect outstanding patient responsibilities following claim adjudication
  • Issue past-due notices for accounts with outstanding balances
• Documentation and Reporting:
  • Maintain detailed records of billing activities, including claim submissions, payments, and denials
  • Generate reports as needed to track billing performance including monthly revenue reporting
• Communication and Coordination:
  • Respond to inquiries from insurance companies, patients/families, and internal team members regarding billing and financial documents
• Compliance:
  • Stay informed about changes in healthcare regulations and insurance policies to ensure compliance with billing procedures

Qualifications

• 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

Requirements

• 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

Benefits

• This role offers a base salary of $60,000-$70,000, which will be determined based on individual experience, qualifications, and market considerations
• This role is also eligible for competitive equity, reflecting the impact and scope of the position at an early-stage, mission-driven company
• Comprehensive benefits including healthcare, 401(k) with matching, and stipends for work-from-home productivity and continued education
• Generous PTO and flexible work hours
• Remote-first culture with supportive team norms
• Inclusive, trauma-informed leadership
• Opportunity to grow with a fast-moving, mission-driven company