Billing and Insurance Administrator

Job Description

Job Description

Description:

The Billing and Insurance Administrator position will work in coordination with Billing Specialists. The person who fills this position will learn registration edits, work queue follow-ups/denials, and billing processes to be able to process self-pay charges. In addition, this position will provide support for provider and facility payer credentialing and enrollment, including provider attestations, and updating Electronic Practice Management system around provider effective dates for payers. As a part of the billing team, this position will also be responsible for the timely follow-up and communication of patient accounts receivable.

This position is primarily remote; however, the Administrator will be expected to commute to the Raleigh, NC office as needed for training, staff meetings, and other occasional in-person events.

Principal Duties and Responsibilities*

• Maintain accurate and up-to-date insurance information in patient records, ensuring proper documentation and timely updates.
• Utilize Availity to research, correct, and complete payment posting aligning with EM.
• Communicate with appropriate agencies and internal contacts to obtain necessary insurance details or resolve eligibility/payment issues.
• Monitor and resolve items in all billing work queues for denials/follow up/claim
• Edit/credit balances and retro review
• Run reports and follow up on bad debt
• Assist with record keeping, sorting, and defining mail and emails.
• Assist Front Desk/Scheduling with insurance-related questions
• Provide customer service to patients inquiring about their accounts and process requests for refunds
• Assist with provider credentialing and payer enrollment processes, including data entry and documentation management
• Assist and monitor Facility/Provider credentialing for renewals in coordination with Credentialing Company.
• Collaborate with internal teams to ensure smooth billing operations and support revenue cycle efficiency
• Communicate with patients, payers, and staff as needed to resolve account-related issues

Required Skills or Abilities*

1. Outstanding communication, interpersonal, and leadership skills to work with the clinical staff and patients.
2. Ability to take initiative and proactively assess processes within the financial assistance department.
3. Computer literacy in internet use and Windows environment, including Outlook, Word, and Excel with keyboarding skills of at least 45 wpm.
4. Ability to cultivate inclusive and equitable working relationships with co-workers and community members.
5. Ability to serve as an advocate for individuals of all ethnicities, genders, ages, and backgrounds.
6. Commitment to demonstrating personal integrity through punctuality, honesty, an ability to follow instructions, proper attention to detail in all work matters, and a willingness learn from others.
7. Ability to work independently, take initiative, set priorities in accordance with the needs and mission of the clinic, multi-task, and problem solve in a fast-paced work environment.
8. Flexibility to adapt to changing or stressful conditions, including unanticipated changes to working schedules or locations.
9. Adequate written and verbal communication skills for communicating coherently and professionally with patients and co-workers.
10. Conscientious of departmental and organizational policies and procedures, and able to embrace and personify the mission of the NHC.
11. Understanding of Medical Health Insurance.
12. Knowledge of CPT coding and UNC EPIC (helpful but not required).

Required Knowledge, Experience, or Licensure/Registration

1. High School Diploma or its equivalent.
2. FQHC or primary health care billing preferred.
3. Accounts receivable follow-up and resolution required.
4. Knowledge of third-party insurance carrier portals and communication required.
5. FQHC or primary health care payer credentialing and enrollment preferred.
6. Experience in customer service, office work, or a clinical setting.
7. Bilingual ability is preferred.
8. Ability to work Mondays through Fridays during the hours of 8am and 5pm.
9. Ability to read, write, speak, and comprehend English fluently.
10. Vaccines as required.

Physical requirements of the Job*

Sitting or standing (often for prolonged periods)

Carrying or lifting objects up to 20 pounds

This is a FT nonexempt (hourly) position.

*To comply with the Americans with Disabilities Act of 1990 (ADA), which prohibits discrimination against qualified individuals on the basis of disability, it is necessary to specify the physical, mental and environmental conditions of the essential duties of the job.

NeighborHealth Center is an Equal Opportunity Employer, including disability and veterans. NHC is dedicated to building a culturally diverse staff committed to serving a diverse patient population.