Job Description

The Billing Coordinator manages Carastars billing and revenue cycle and the processing of payments from Medicaid, Medicare, and Commercial payers. Also, the coordinator will lead and supervise a team of billing specialists. SUPERVISORY RESPONSIBILITIES: Reviews work of billing staff to ensure accuracy, resolving inconsistencies as needed. Trains and supervises the billing specialists. Conducts timely employee performance evaluations. Responsible for employees timecard approvals and corrections. Conducts, at least, monthly meetings with billing staff Maintains and updates payer fee schedules and sliding scale fee schedules as needed. Closes accounting periods monthly. Assists with insurance credentialing for the organization. DESCRIPTION OF DUTIES: Verify insurance coverage to include Medicaid, Medicare, and Commercial insurances. Prepare, review, and transmit 837 files and manual claims to insurance companies for mental health and primary care services. Process electronic and manual insurance and self-pay payments using the billing software. Responsible for obtaining insurance prior authorizations and referrals for Case Management, Behavioral Health, and Primary Care services. Follow up with insurance companies on unpaid or rejected claims. Resolve any issues and resubmit the claims in the timely filing period. Review insurance remittances for billing errors, make necessary corrections, and resubmit claims when needed. Prepare monthly patient statements. Rectify delinquent accounts by setting up payment plans and monitoring payments. Research clients account balances for accuracy and completeness. Answers clients questions about their account balances and billing concerns. Assist with correcting services for the State reporting upload. Maintain continuing education by participating in educational opportunities. Perform other duties as requested by Supervisor. REQUIREMENTS: Knowledge of Medicaid, Medicare, and Commercial billing rules. Experience with billing medical claims, both electronic and paper. Knowledge of insurance processes and procedures and diagnosis coding (CPT/ ICD-10). Experience in accounts receivables. Knowledge and experience with Microsoft Excel, Word, and Outlook. Experience with medical billing software application systems and electronic health records software. Strong problem-solving skills and time management skills. Strong attention to detail skills. Ability to drive and work at each location as needed. Prolonged periods of sitting at a desk and working at a computer. QUALIFICATIONS Associate degree in business administration, accounting, or related field, plus two years of supervisory experience OR Certification in Medical Billing (preferred), plus two years of supervisory experience OR High school diploma plus five years of experience as a Medical Biller, experience with direct medical billing with Medicaid, Medicare, and Commercial Insurance, plus two years of supervisory experience. Must hold a valid drivers license and maintain a driving record that is acceptable to Carastar Healths insurance carrier. Must maintain at least liability coverage on personal vehicles.

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