Job Details
Description
**Voted Raleigh’s Best Nonprofit Organization and Raleigh’s Best Mental Health Services two years in a row!**
The Program Billing Coordinator functions primarily to oversee all aspects of program-specific billing, ensuring accuracy, efficiency, and compliance in claim processing and payment. Collaborating closely with program leadership, the Finance/Claims Department, and Health Information and Technology (HIT), this role is integral to the seamless flow of financial operations. The Program Billing Coordinator is responsible for communicating directly with clients regarding insurance benefits and service eligibility, as well as working with external payors to resolve discrepancies and facilitate timely payments. This position plays a key role in supporting the financial integrity and operation success of the program.
Essential Job Functions
- Verify client insurance benefits and eligibility: Conduct frequent checks to confirm client coverage and service eligibility, ensuring compliance with insurance requirements.
- Navigate insurance portals: Obtain benefit details, submit and monitor authorization requests, and track claim statuses to ensure timely processing.
- Maintain accurate client information in EHR: Ensure all client data is current and that accounts are configured correctly for billing and claims.
- Resolve billing issues: Investigate and resolve discrepancies in collaboration with internal departments and external stakeholders to ensure smooth billing operations.
- Review and verify billing data: Confirm the accuracy of all billing details, including rates, hours, services provided, and program-specific information.
- Prepare financial reports: Generate detailed reports for program managers and finance teams, summarizing billing activity, revenue, outstanding balances, and comparing actuals to budget projections.
- Communicate with clients and payors: Address inquiries regarding invoices, payments, authorizations, or adjustments in a timely and professional manner.
- Manage service authorizations: Prepare and submit authorization documentation in accordance with payor policies and timelines, and update authorization records and supporting documents in the EHR.
- Follows: All ESPH procedures as appropriate to position.
Minimum Qualifications
- Education: High School diploma or equivalent required.
- Experience: At least 2 years of experience (3 years preferred) in medical billing, healthcare benefits administration, and proficient use of payor portals for claims management and benefits verification. Familiarity with EHR systems at an administrative level is essential.
- Language Proficiency: Strong command of English with a solid understanding of U.S. healthcare, billing, and claims terminology.
- Attention to Detail: Demonstrated accuracy and attention to detail in financial reporting and billing processes.
- Organizational Skills: Excellent organizational and time management abilities, with the capacity to handle multiple projects simultaneously.
- Communication Skills: Strong interpersonal and communication skills, with the ability to collaborate effectively with external payors and internal program teams.
- Confidentiality: Proven ability to handle sensitive and confidential financial information with discretion.
- Problem-Solving Abilities: Strong problem-solving skills and the ability to resolve complex billing issues efficiently.
- Current: unrestricted NC Driver’s license and valid personal vehicle insurance.
