Medical Billing Eligibility and Authorization Coordinator

Job Description

Job Description

POSITION SUMMARY :

As an internal and external client-facing professional, the Medical Billing and Eligibility and Authorization Coordinator is a key position in the Revenue Cycle, manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries / correspondence. The incumbent will assist in the clarification and development of process improvements and inquiries, assure payments related to patient services from all sources are recorded and reconciled timely in order to maximize revenues. Other important duties include credentialing, enrollment processing, and reporting for the San Diego Cardiac Center (SDCC).

PRIMARY DUTIES AND RESPONSIBILITIES : The primary job functions required of our Medical Billing and Eligibility and Authorization Coordinator includes the following, but not limited to :

• Coordinate the process of patient eligibility through various sources
• Work with reception staff, ensure appropriate collection of copays, spend down and self-pay fees
• Handling inquiries and answers questions from patients, clinic staff and insurance companies
• Identify and resolves patient issues related to referrals, authorizations, and eligibility problems
• Handle eligibility denials with insurance and patients
• Communicate problems to the appropriate Supervisor or Manager
• Maintain strictest confidentiality; adhere to all HIPAA guidelines / regulations

Other Miscellaneous and Related Tasks

CORE COMPENTENCIES AND EXPECTATIONS : A successful Medical Billing and Eligibility and Authorization Coordinator will possess the necessary core competencies and meet the general expectations, such as :

WORKING ENVIRONMENT :

The position may involve sitting for long periods of time, standing, bending, and stooping.

Ability to function in a fast-paced / high stress healthcare office environment, which may involve dealing with a high traffic volume of people and stressful situations requiring the ability to think clearly; respond quickly; and to be able to perform multiple tasks simultaneously.