Medical Billing Coordinator Level 2

Medical Billing Coordinator Level 2

The Medical Billing Coordinator Level 2 will be responsible for identifying claims that do not have charges, have not billed, and have edits based on payor requirements. Once identified, responsible for obtaining the information required to resolve the error/edit and generate a clean claim. Responsible for the distribution of the invoicing and billing spreadsheet to the appropriate Medical Billing team members.

Essential functions include but are not limited to:

• Answers questions from patients, co-workers and insurance companies.
• Obtain and update patient demographic information accurately.
• Successfully works between 60 and 80 invoicing and billing errors and claim edits per day with resolution (any combination).
• Responsible for maintaining the claims queue (claim edits).
• Receive the Invoicing and Billing spreadsheet from the Medical Billing Manager.
• Assign claims to the appropriate Medical Billing team members.
• Escalates any complex invoicing and billing errors and claim edits to the Level 3 or Medical Billing Manager.
• Collect completed claims assignments from team members and reports back to Medical Billing Manager on progress.
• Responsible for correcting or taking next action on invoicing and billing errors and claim edits. This includes escalating complex invoicing and billing errors and claim edits to the Level 2, 3 or Medical Billing Manager.
• Required to contact patients for updated demographics.
• Required to contact Payors to clarify cause of edit.
• Communicate with Level 1 on the status of their faxes to ensure completion.
• Level 1 should be faxing the information (requests for diagnosis codes, or other required documentation etc.) to clients in order to process claims
• Escalate any unanswered faxes to the Medical Billing Manager for resolution.
• Distribute returned faxes to Coding Team for updated diagnosis codes
• Identify trends and patterns of claims edits or errors and suggest possible system corrections to the Medical Billing Manager.

Participates in educational activities and attends monthly staff meetings. Conducts self in accordance with employee manual. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations. Performs other duties as requested.

Job specifications:

Education required:

Associates degree in HIT, Health Administration, Business, etc. or a Medical Billing & Coding certification is required. Bachelor's degree in a related field is preferred. Nationally certified Medical Biller & Coder is highly desired.

Experience required:

3 - 5 years of experience in a medical billing or related position is required.

Skills required:

• Intermediate understanding of an explanation of benefits (EOB)
• Intermediate knowledge of CPT, ICD-10 and HCPCS coding standards
• Knowledge of computer programs.
• Knowledge of business office procedures.
• Ability to operate a computer and basic office equipment.
• Experience in answering a telephone in a pleasant and helpful manner.
• Ability to read, understand and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, clients, employees and the public.

• Must be well organized and detail-oriented.