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Billing Coordinator

Steward Health Care
Brighton, MA
Full-time

Billing Coordinator (Psychiatric Opd / tx department)- Full-time day shift 40hrs / wk, (7 : 30am-4pm) no weekends or holidays required.

Position Function :

Performs prior authorization and billing functions.

Job Relationships

Reports to Director of Psychiatric Services

Responsibilities / Essential Functions :

  • Provides superior customer service to internal and external clients, customers, and patients as referenced in the Service Excellence Standards.
  • Ensures that patients are appropriately registered. Corrects problematic registrations through admitting and / or billing areas.

Requests assistance of clinicians and coordinator as needed.

  • Ensures that services are pre-authorized as required by payers.
  • Obtains pre-authorizations / approvals for outpatient and inpatient services as needed.
  • Confirms ongoing authorization for treatment and obtains continuing authorization. If clinician involvement is required, informs clinician of necessary actions they must take.
  • Enters charges electronically.
  • Assures the final diagnoses and operative procedures as stated by the physician are valid and complete with the guidance of the system edits and reports.
  • Obtains any necessary clarification of information on the notes and charts.
  • Prepares the appropriate claims documents required by each insurer.
  • Submits, organizes, and tracks all insurance claims filed by the health care provider.
  • Follows up until payment is received and manages collections activities when necessary.
  • In addition to administrative duties, required to perform a variety of customer service functions. These often include answering patient questions on billing and handling collections if a patient fails to meet his or her financial obligations.
  • Maintains communication between clients, families, and internal departmental personnel to ensure exchange of information related to billing.
  • Participates in ongoing improvement of billing and charge capture standards and procedures.
  • Performs all charge follow-up such as edits, submission of supporting documents, and correction of codes, incorrect insurance, or incorrect demographics.
  • Identifies denial patterns.
  • Works in several billing and collections systems to reduce or correct denials.
  • Collects copayments and outstanding balances.
  • Utilizes all insurance verification systems.
  • Orders all medical supplies and office supplies.
  • Supports cross coverage for the front desk.
  • Performs other duties as assigned to support departmental needs.

Qualifications : Minimum Education :

Minimum Education :

High School diploma.

Minimum Experience :

  • 2+ years of previous billing experience required.
  • Experience is health care setting strongly preferred.

Minimum skills / abilities :

  • Computer software competencies (MSWord suite, ability to quickly learn to schedule and charge entry systems).
  • Good organizational skills.
  • Ability to return to tasks and follow-up on issues requiring multiple interventions.

Certification / Licensure :

Billing and coding certificate preferred.

Steward Health Care is proud to be a minority, physician owned organization. Diversity, equity, inclusion and belonging are at the foundation of the care we provide, the community services we support and all our employment practices.

We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.

30+ days ago
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