Job Summary:
The Medical Billing Coordinator is responsible for coordinating and overseeing medical billing functions to ensure accurate claims submission, timely reimbursement, and compliance with payer and regulatory requirements. This role plays a critical part in maintaining the financial performance of the practice by managing billing workflows, resolving claim issues, and supporting revenue cycle operations.
Working closely with clinical staff, front office teams, and insurance carriers, the Medical Billing Coordinator ensures charges are captured correctly, claims are processed efficiently, and patient accounts are handled professionally. The position also serves as a resource for billing questions and supports process improvements while maintaining strict confidentiality in accordance with HIPAA standards.
Essential Functions:
- Coordinate daily medical billing activities, including claim generation, submission, and follow‑up.
- Review and verify coding and charges for accuracy prior to claim submission.
- Submit electronic and paper claims to commercial insurance, Medicare, Medicaid, and other payers.
- Monitor claims and follow up on rejected claims in a timely manner.
- Investigate and resolve billing discrepancies, coding issues, and payment variances.
- Respond to patient and staff inquiries related to billing balances, insurance payments, and coverage.
- Work closely with the client to ensure accurate demographic and insurance information.
- Assist with aging accounts receivable management and collection efforts.
- Maintain accurate billing documentation within the practice management and billing systems.
- Ensure billing processes comply with payer contracts, regulatory standards, and organizational policies.
- Maintain confidentiality and security of protected health information (PHI) in accordance with HIPAA.
- Assist in process improvements to enhance billing efficiency and reduce claim denials.
Qualifications:
Education:
- High school diploma or equivalent required.
- Associate’s degree in healthcare administration, medical billing, or related field preferred.
Experience:
- Minimum of 2–3 years of medical billing experience in a healthcare setting required.
- Experience billing commercial insurance, Medicare, and Medicaid preferred.
- Familiarity with specialty‑specific billing is a plus (e.g., OB/GYN, surgical, primary care, wound care).
Knowledge, Skills, and Abilities:
- Strong understanding of medical billing procedures, insurance guidelines, and reimbursement processes.
- Working knowledge of CPT, ICD‑10, and HCPCS coding preferred.
- Experience using electronic health records (EHR) and practice management systems.
- High level of accuracy and attention to detail.
- Strong organizational and time‑management skills.
- Excellent written and verbal communication skills.
- Ability to work independently and collaboratively in a fast‑paced environment.
- Problem‑solving mindset with the ability to manage multiple priorities.
- Commitment to professionalism, confidentiality, and patient service.