Billing Coordinator

BillingCoordinatorfy26 (003).docx Position Title: Billing Coordinator Division: Business Office Reports To: Business Office Manager Job Summary: Billing Coordinator handles third-party insurance billing, reviews medical information for accurate claims, collaborates with coders, and addresses denials, errors, and recurring issues to ensure proper reimbursement.

Essential Functions

The following functions are fundamental to the position and are required of all incumbents, with or without reasonable accommodation. These functions define the role and are not an exhaustive list of all duties. Prepare, process and submit clean claims to various insurance claims according to payer guidelines and deadlines either electronically or by paper.

Obtain knowledge on dental billing within the dental billing platform Obtain knowledge on pharmacy billing processes Obtain knowledge on Honor Every Woman program Obtain knowledge on Worker’s Compensation/Attorney claims Maintain current knowledge and understanding of each insurance payer’s rules, regulations and deadlines and apply this knowledge in daily duties and assignments Recognize and identify errors and communicate these to insurance payers Billing Coordinator II or III. Monitor and reconcile delinquent accounts. Documented ability to prioritize workload and meet quality and production standards.

Effectively communicate with clearinghouse and insurance companies regarding claim status, including rejections, denials, corrections and other various issues. Communicate with coding department regarding coding-related denials needing correction. Provide appropriate third-party account status and any issues to Lead Biller or Business Office Manager. Responsible for daily clearinghouse reconciliation of reports and claims. Answer questions from patients, clerical staff, tribes, subcontractors and insurance companies. Perform various collection actions including contacting by phone, correcting and resubmitting claims to third party payers.

Participate in CMS, IHS and private insurers’ educational activities as necessary. Conduct self in accordance with GPTLHB’s employee manual. Maintain strict confidentiality; adhere to all HIPAA guidelines/regulations. Perform other related duties as assigned. Education/Experience Minimum Qualifications: High school diploma or GED and one (1) year of medical billing experience.

Preferred Qualifications

Experience with RPMS and EHR preferred but not required. Excellent verbal and written communication skills with the ability to be detail oriented Computer and technical skills (including Word, PowerPoint, Excel, Outlook, etc.). The GPTCHB is a tribal organization that follows tribal preference laws. Our policy is to give preference to qualified Indian/Tribal candidates over a qualified non-native candidate in hiring decisions if all other qualifications are equal. Employment is contingent upon the outcome of all required criminal background checks. Compliance with our Employee Health…

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