Position: Program Billing and Coding Support Coordinator Status: Full Time Non-Exempt Reports to: Sr. Revenue Cycle Administrator Job Summary: The primary responsibility of the Billing and Coding Supports Coordinator is to support the clinical documentation for proper coding ensuring correct claim submission resolving billing discrepancies tracking reimbursements and providing administrative support related to billing cycles. The coordinator also serves as a liaison between clinical departments and billing personnel to support program efficiency compliance and revenue integrity. Primary Duties and Responsibilities - Understanding and interpreting state documentation and policies related to program benefits and billing.
- Working with the Electronic Health Record (EHR) team to ensure accuracy and efficiency in billing and coding processes.
- Providing training and support to front-end staff on billing and coding procedures.
- Verifying patient insurance eligibility and benefits: initial intake and subsequent visits.
- Verification of insurance policies and member ID in the county portals are aligned with our EHR system.
- For clients with no insurance refer to the Program for Medicaid application.
- Assisting with the management of coding and billing teams.
- Organizes and prioritizes the duties of billing support staff to ensure all activities are completed in a timely manner.
- Works with support staff to explain the situation and responds to questions related to the billing and payment entry process.
- Provides in person onboarding/training to new and existing program staff.
- As a benefits coordinator works with support staff to explain the situation and responds to questions related to the billing and payment entry process.
- Development of staff training program and making updates as needed.
- Identifies issues with coding submissions and works to achieve corrections and performance improvements.
- Audits medical record documentation to identify miscoded and under/up coded and training on accurate coding practices and compliance issues.
- Provide support to the billing department for various tasks
- Completes any and all other duties as assigned by supervisor.
Qualifications - Associates or bachelors degree preferred in Health Administration Social work or a related field.
- Certification in billing/coding preferred
- Valid Michigan drivers license or State ID required
- Medical billing experience at a comparable behavioral health or health and human services agency.
- Strong understanding of medical terminology billing regulations and coding practices (CPT ICD-10 HCPCS).
Skills Required - 2-3 years of benefit coordination billing or patient services experience required.
- In-depth knowledge of Medicaid behavioral health services and third-party insurance processes.
- Familiarity with state-specific Medicaid regulations and managed care organizations (MCOs).
- Ability to work with minimal supervision
- Knowledge of EHR systems (ex. Netsmart Eclinical).
- Familiarity with 837 billing and importing of files.
- Familiar with behavioral health billing including the ability to accurately complete fee agreements HCFAs interpret EOBs and negotiate accordingly when applicable
- Problem solving skills especially with software issues related to billing processes
- Ability to provide culturally competent services that shows sensitivity to the service populations cultural and socioeconomic characteristics.
Working Conditions - Generally an office environment with a cubicle/office or reception area workstation.
- Ability to travel and attend meetings at various locations may be required.
- Some non-traditional hours such as evenings or weekends may be required.
| Required Experience:
IC