Job Description

Overview Job Summary: The Billing Coordinator is responsible for overseeing all billing and revenue cycle management functions for the practice. This role ensures accurate and timely submission of claims, efficient client billing processes, and effective communication with clients, staff, and payers. Responsibilities Prepare and submit accurate insurance claims using electronic health record system Review clinician documentation to ensure accurate billing types, demographics, and coding Track claim status and resolve rejections and denials within prescribed timeframes Identify trends and/or issues with claims payment, research, and follow up with payer to resolve Post insurance payments accurately, reconcile deposits, and maintain accurate billing records Collect patient responsibility amounts, including copays, deductibles, coinsurance, and self pay Generate and review Verification of Benefits and communicate important coverage information to clients and prospective clients using plain language Request all necessary documents, including referrals, physician’s orders, and prior authorizations Proactively communicate with clinicians regarding coverage issues Track visit limits and other issues impacting insurance coverage and payment status Set up and manage payment plans as needed Review all forms and information provided by clients to ensure accuracy of data Manage the full credentialing and re-credentialing process for clinicians with insurance companies, including completing CAQH profiles, submitting applications, and maintaining up-to-date provider files. Maintain compliance with HIPAA and insurance requirements or standards Update knowledge base regarding payer policies related to billed services Document billing activity and maintain organized records for auditing and reporting Identify and resolve inefficiencies in the billing process Collaborate with admin team and leadership to develop or refine billing policies and procedures Align behaviors and communication in connection to the practice’s mission and values Required Knowledge/Skills/Abilities Strong knowledge of CPT and ICD-10 related to dietetic and mental health services Proficient in billing software and EHR systems Strong attention to detail and accuracy Ability to communicate clearly and empathically Highly professional and ethical Must be punctual in reporting to work Ability to work independently and as part of a team Exceptional time management and prioritization Problem solving and follow through Required Education/Licenses/Experience High School diploma or equivalent Minimum of 2 years of recent experience in medical billing and coding using electronic medical billing platform. Outpatient medical billing certification preferred Experience working with a vulnerable health/patient population. Work Location Hybrid. Incumbent must reside in the state of Massachusetts within commuting distance of Newton and Framingham offices. This position may require occasional presence in the office for training, office coverage, or special events. Physical Requirements Position requires being stationary frequently with occasional need to traverse; constant need to use standard office technology, such as computer/laptop, and frequent verbal communication. #J-18808-Ljbffr Metrowest Nutrition

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