Billing Coordinator

Basic Functions

The Billing Coordinator coordinates the billing functions for hospital claims (facility and professional) to ensure timely and accurate processing of insurance claims to appropriate carriers for accurate payment. Keeps abreast of all payer updates and changes regarding policies and procedures pertaining to medical billing guidelines. Demonstrates strong knowledge of UB04 occurrence codes, value codes, HCPCS/CPT codes, modifiers, as well as CMS 1500 specifics for claims submission and acceptance. Provides training to Patient Account Staff on pertinent changes/revisions in billing policies and procedures. Responsible for claim accuracy. Takes the lead in working the claims management vendor to develop applicable systems for NCMH, in addition to system enhancements and upgrades. Serves as the primary trainer of relevant staff on the electronic claims and remittance advice processing system. Works closely with Patient Accounts management and IT resources to ensure all claims management systems are programmed for workflow optimization. And clean claim submission goals. Maintains billing data metrics and logs for management. Responsible for Provider Enrollment/Credentialing as requested. Works closely with key personnel such as, Charge master Coordinator, HIM coders and clinical department revenue representatives to ensure accurate and timely claim submission.