Billing Coordinator

Job Details Level Experienced Job Location The Good Shepherd - Ashland, OH Position Type Full Time Education Level 2 Year Degree   Salary Range $20.00 - $23.00 Hourly Travel Percentage None Job Shift Day Job Category Admin - Clerical Billing Coordinator General Summary: Responsible for Billing, Census reporting, and miscellaneous audits/reports as needed. Billing Coordinator retrieves billing, coding, and charges from the Electronic Health Record (EHR), reviews claims through triple check and submits claims for reimbursement; works with team members to define appropriate charges and coding for the scope of services delivered. Seeks training and guidance for billing and coding to help increase revenue; works with Medicaid, Medicare, Managed Care Organizations (MCO), and private health insurance groups to obtain payment for services and comply with credentialing and certifications. Essential Duties and Responsibilities: Captures charges from the EHR and other billing systems for services provided on a regular basis according to defined revenue cycles. Verify that the Therapy Verification form has correct payers. Submits claims for payment to Medicaid, Medicare, MCO's, and other payer sources. Follows up with payer sources to resolve unpaid claims. Reports on billing activities each month, including charges, payments, and aging, claims denied, and other related data as needed. Coordinates collection efforts internally with BOM Provides guidance for staff members regarding coding and billing within the scope of services for the provider. Coordinates with residents/resident representative to ensure accurate and verifiable billing information. Identifies responsible party by examining patient record. Works cooperatively with other departments to share demographic and insurance information. Resolves billing issues by discussing contract with third-party payer, explaining insurance contract with patient. Insurance credentialing/Contracts Import ancillaries in PCC monthly and post. Prepare for Audits/Reports (Monthly/Quarterly/Yearly) as directed by BOM, Administrator and CFO. Updates in PCC Perform other duties as assigned. REPORTING RELATIONSHIPS SUPERVISES: N/A QUALIFICATIONS EDUCATION: High School Diploma and equivalent work experience required EXPERIENCE: Previous long term care healthcare billing experience preferred Point Click Care experience preferred REQUIRED KNOWLEDGE, SKILLS & ABILITIES Knowledge of healthcare billing systems, claims software, EHR's, and Microsoft Office package. Data processing, reporting, and analysis related to billing and accounts receivable. Decision-making abilities. Problem-solving abilities. Ability to reason. Ability to communicate both verbally and in writing with a wide range of people. Detail-oriented. Ability to maintain confidentiality. OTHER REQUIREMENTS: Physical Requirements Rarely (0-12%) Occasionally (12-33%) Frequently (34-66%) Regularly (67-100%) Seeing: read reports and use computer X Speaking & Hearing: communication with clients and co-workers X Standing/Walking X Climbing/Stooping/Kneeling X Lifting/Pushing/Pulling up to 25 lbs X Lifting/Pushing/Pulling 25-50 lbs X Lifting/Pushing/Pulling 50-100 lbs X Lifting/Pushing/Pulling over 100 lbs X Fingering/Grasping/Feeling: write, type, use phones, etc... X Sitting for extended periods of time X Working Conditions Normal office working conditions with the absence of disagreeable elements. Note: The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.

Created: 2024-10-29