BILLING COORDINATOR

Major Responsibilities

• Identifies and resolves billing queries/problems.
• Researches and processes denied claims (Returns).
• Prepares correspondence and/or collection letters.
• Communicates with MCOs to answer questions and provide additional supporting documentation.
• Prepares letters of appeal to MCOs if the company refuses to pay contracted claims and/or denies a claim; submits documentation necessary to support claim; resubmits claims with corrections if needed for payment for all insurance payers.
• Enters data and charges from charts into the billing system; generates all required reports.
• Utilization review to ensure clinical records support billing.
• MCO prior-Authorization coordination and tracking of units.
• Creates MCO-staff rosters and credentialing.
• Generates MCO data reports weekly.
• Generates Avatar and BHL reporting and data analysis.
• Liaise with LA Dept of Health and MCO's under direction of PD CARELON data system and reports.
• Performs other administrative duties as assigned by manager.
• BH First Responder when needed or scheduled.

Job Qualifications and Competencies

• High school diploma or equivalent. (GED)
• Associates degree preferred.
• Knowledge of MCO billing/collection practices.
• Minimum two (2) to four (4) years related experience.
• Excellent written and oral communication skills.
• Knowledge of medical billing terminology.
• Ability to perform diversified clerical functions and basic accounting procedures.
• Ability to effectively communicate with people at all levels.
• Commitment to excellence and high standards.
• Strong organizational, problem-solving, and analytical skills.
• Ability to meet deadlines and manage priorities and workflow.
• Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.
• Acute attention to detail.
• Ability to work independently and as a member of various teams and committees.
• Proficiency in MS Office programs and customized billing software.
• Excellent customer service skills.
• Ability to understand and follow written and verbal instructions.
• Accurately complete detailed forms and reports.