Billing Coordinator performs administrative, operational, and quality assurance functions to support the billing process. Coordinate with physician practices to ensure the accuracy of claims. Provide administrative support, performs clerical and customer service functions, as well as non-technical duties.Reports to: Dir Physician Practice
* Serve as primary point of contact for all revenue cycle processes and follow up requests related to charge posting, accounts receivable, payment and patient account activities, for both hospital clinics, freestanding clinics, and PMDS.
* Provide training, feedback and assistance to clinic staff relating to pre-visit revenue cycle impacting processes, including demographic and insurance entry/information, patient TOS payment collection, eligibility verification, authorizations and provider credentialing.
* Oversee and perform bank/payment reconciliation/balance processes, as well as any clinic deposit and cash reconciliation processes.
* Conduct onsite clinic cash drawer reviews and reconciliations.
* Periodically review clinic charge posting activities for compliance and adherence to accepted practices and documented processes, as well as assist in posting hospital/clinic charges when necessary to ensure all revenue is captured by month end.
* Review/respond to/resolve claim scrubs, front-end denials, back-end denials, and appeals where responsibility is designated, including providing training, feedback, and assistance to clinic staff in preventing the recurrence of problematic claims.
* Monitor and maintain enrollment checklists, claims/billing coordinator worklists, and unpostables dashboard.
* Provide PMDS and clinics with requested feedback, respond to general inquiries, process paper-based requests, assist with/locate missing EOBs, assist with patient billing phone calls, and ensure patient bad addresses/returned mail are reconciled.
* Assist with insurance/patient refunds processing and reconciliation between accounting and PMDS, including reviewing refunds lists, obtaining check numbers for refund checks processed, and assisting in the overall unapplied credits process.
* Oversee and monitor 3rd party payer/provider/department enrollment processes and ensure timely communication of changes/updates to clinics, PMDS and other impacted parties.
* Gather, compile, and upload all necessary information for payor enrollment of all providers.
* Collaborate with PMDS and other LifePoint hospitals/corporate departments to disseminate best demonstrated practices
* Ensure compliance with all relevant regulations, standards, and laws.
* Provide a billing summary and letter of explanation for each patient dispute requesting collection balances within TSI.
* Complete and submit Athena PAD forms for new providers.
* Work on special projects, as needed.