Billing Coordinator I

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

• Serve as backup for other employees for breaks and absences as needed
• Perform other duties as assigned

Qualifications

• High School Diploma required
• 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

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.