Description

The Billing Coordinator will lead EP!C’s billing activity through generating claims, creating invoices, coding payments, and addressing denials. This role will be instrumental in maximizing the collectability of claims through accurate billing, obtaining prior authorization for some Behavioral Health services, and promptly following up on claims denials. The Billing Specialist will also assist in the process of credentialing EP!C with new insurance providers and other payers. The person fulfilling this role will collaborate with members of the Accounting and Behavioral Health teams to support timely, accurate, and compliant billing operations.

Requirements

Education and Experience Requirements

1.       High School Diploma or GED Certificate.

2.       Further education or certification(s) in healthcare administration, healthcare billing, credentialing, or a related field preferred.   

3.   4 years of experience with healthcare billing, invoicing, and collections in the state of Illinois.

4.       Proficiency in generating and managing claims and payments in an electronic health record (EHR) system.

5.       Experience obtaining pre-authorization for services.

6.       Experience credentialing and facilitating contracts with insurance providers in the state of Illinois preferred.

Knowledge, Abilities, and Skills:  

• Knowledge of CPT, ICD-10 codes, and medical billing terminology.
• Exceptional attention to detail.
• Willingness to learn and adopt processes defined by Accounting and Behavioral Health staff members.
• Proficient in MS Excel (pivot tables, filters, sorting, and basic data transformation).
• Excellent organizational and time management skills.
• Ability to communicate effectively in written and verbal forms.
• .       Strong ethical conduct.

Physical Requirements

•        Frequent walking and sitting.
•        Regular reaching, grasping, and standing.
•        Other physical activities related to an office environment.
•       Operates general office equipment, including multi-line phone, fax machine, printer, copier, and personal computer.
•        Ability to lift 50 lbs.

Summary

Mission, Vision, and Values

•        Support the agency’s mission, vision, values, and strategic plan philosophy.
•        Manage all responsibilities based on the agency's mission, using individual choice, and all appropriate policies, procedures, and regulations.
•        Conduct oneself in a way that reflects the highest standards of professional courtesy and ethical practices to people served, staff, guardians, families, and all outside contacts.

• Department/Program Development and Coordination (Delivery of Quality Service)
• Generate claims and post invoices on a weekly to monthly basis.
• Receive and code payments including EFTs, paper checks, and other forms of payment.
• Address and potentially rebill denied claims to ensure maximum collectability.
• Obtain prior authorization for some services.
• .       Manage and resolve patient billing inquiries, questions, and complaints.
• Perform regular audits of submitted claims and payment results to ensure accuracy and compliance.
• Maintain up-to-date knowledge of coding, billing, and regulatory standards of payers operating in the state of Illinois.
• Assist in the credentialling and contracting process with new insurance providers and payers.
• Assist Front Desk Associate with verifying patient insurance information and eligibility.
• Assist Revenue Cycle Manager in ensuring accurate and timely creation of staff documentation and notes.
• Provide future billers with expertise and support.
•        Serve on committees/task forces as assigned.
•       Complete tasks as assigned by accounting team members.
•        As a mandated reporter, ensure all allegations of abuse and neglect are reported as required.
•        Ensure compliance with all HIPAA and confidentiality requirements.