Claims Coordinator
Beacon Behavioral Hospital
Claims Coordinator
The Claims Coordinator is responsible for reviewing, validating, and correcting claims before they are submitted to insurance payers. This role ensures the accuracy and completeness of claims to minimize rejections, denials, and payment delays. The ideal candidate has a strong understanding of medical billing practices, payer requirements, and coding standards (ICD-10, CPT, HCPCS).
Experience in mental health is required.
Key Responsibilities:
- Review claims for completeness, coding accuracy, and payer-specific compliance prior to submission.
- Identify and correct errors or inconsistencies in claims data, including diagnosis and procedure codes.
- Work closely with coding, billing, and provider teams to resolve discrepancies or missing information.
- Utilize claim-scrubbing software and electronic health record (EHR) systems to process and validate claims.
- Stay current on payer guidelines, CMS updates, and regulatory requirements.
- Monitor and report trends in claim errors or rejections to support quality improvement efforts.
- Assist with claim re-submissions and appeals as needed.
- Review all claim rejections, correct, and resubmit claims.
Qualifications:
Required:
- High school diploma or equivalent.
- 12 years of experience in medical billing or claims processing.
- Familiarity with ICD-10, CPT, and HCPCS coding systems.
- Strong attention to detail and analytical skills.
Preferred:
- 12 years of experience in mental health/psychiatry
- Knowledge of payer policies including Medicare, Medicaid, and commercial insurance plans.
Skills:
- Excellent communication and organizational skills.
- Ability to work independently and manage multiple priorities.
- Problem-solving mindset with a focus on accuracy and efficiency.
- Comfortable working in a fast-paced, deadline-driven environment.
Work Environment:
In office, Legacy Towers, Plano, TX
Office hours 7:30am-4pm CST or 8am-4:30pm
Beacon Behavioral is an Equal Opportunity Employer.
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