Billing Coordinator at CAIPA MSO LLC

The Billing Coordinator (Generalist) is responsible for multiple components of the billing process, including Charge Entry, Edits, Payment Posting / Reconciliation, Accounts Receivable (denials and appeals). Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution.

Duties:

Verifies insurance and registration data for scheduled office, outpatient, and inpatient encounters and scheduled surgeries; reviews encounter forms for accuracy. May be responsible for obtaining pre-certification for scheduled surgeries and admissions

Enters office, inpatient, and/or outpatient charges with accurate data entry of codes. Ensures charges are entered/processed in accordance with policies and procedures

May run workbench reports and communicate with appropriate parties for missing charges

Posts payments / adjustments from paper EOBs and ERAs using approved methodologies with strong reconciliation skills.

May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staff

Works system edits and clearinghouse rejections. Proficient in moderate to complex encounters and problematic accounts

Works daily Accounts Receivable accounts via online workfile and/or hard-copy reports; checks claim statuses, re-submits claims, edits, denials and process appeals which includes submit claim reconsiderations and writes appeal letters on a timely basis

Researches unidentified / missing checks and communicate with appropriate parties for replacements

Works credit balance report to ensure adherence to government regulations/guidelines

Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendations

Identifies and assists in resolves credentialing issues

Meets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concerns

Mentors less experienced Billing staff and assists Billing Manager/FPA Manager in training new staff

May be responsible for collection of time-of-service payments, and maintaining daily transaction record of collected payments

Maintains working knowledge and current in third party payer requirements

• Associates Degree or high school diploma/GED plus 3 years of relevant experience
• CPC Preferred
• Trained in computerized medical billing
• 3 years' experience in medical billing or health claims in a health care or insurance environment, and familiarity with ICD/CPT coding

Benefits

• Health Benefits: Medical, Vision and Dental
• 401k retirement plan
• Paid Time Off
• Hybrid Work Model

Salary Range:

• 40k-60k

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