CDI Specialist

Billing Coordinator

The billing coordinator will review patient medical records and assign codes to diagnoses and procedures performed so the facility can bill insurance and other third-party payers (such as Medicare or Medicaid) as well as the patient. Duties and responsibilities include determining patient invoice by capturing services noted in patient chart; clarifying services with physicians. Identifying responsible party by examining patient record. Issuing invoice by entering service data; calculating charges; mailing invoices. Resolving billing issues by discussing contract with third-party payer; explaining insurance contract with patient; negotiating settlement. Reviewing and evaluating tools for accuracy and adherence of medical encounters to accepted national industry standards, plan benefits and authorization guidelines. Maintaining patient and invoice files by entering and adjusting data. Providing billing information by collecting, analyzing, and summarizing third-party billings, accounts pending, and late charges data and trends. Assisting with credentialing process for onboarding physician(s). Following up with insurances to ensure physician(s) added to the group contract. Maintaining physician credentialing files. Assisting with data entry as needed. Assisting with patient billing inquiry. Performing other duties as needed.

Qualifications: Education/Experience: Must have high school diploma or equivalent. Certified in medical billing and coding. Experience with Medicaid and Medicare preferred. MS Office programs experience (Word, Excel, PowerPoint, etc.). At least one year of experience in billing and coding. Skills: Experience reporting research results and analyzing information. Experience using HEDIS measurements. Data entry skills. Thoroughness and attention to detail. Use relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards. Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices. Ability to work with individuals within and outside the organization, in professional and courteous manner. Demonstrated ability to successfully plan, organize, and manage projects. Understand written sentences and paragraphs in work-related documents. Organized and able to manage competing priorities. Resourcefulness in problem solving. Actively look for ways to help people. Strong written and verbal communications skills. Strong organizational and interpersonal skills. Excellent customer service skills. Must be highly flexible; able to accommodate changing needs of the department. Knowledge of computerized data management system, statistics principles, and the ability to quickly develop in proficiency to meet the demands of the position. Bilingual skills preferred (English/Spanish or English/Creole).