The Billing Coordinator, Ophthalmology reflects the mission, vision, and values of NM, adheres to the organization鈥檚 Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
The Billing Coordinator is responsible for assisting patients with billing and insurance matters related to specialized services rendered in the clinic. This person will assist patients with payment of their bills by establishing payment plans when complete insurance coverage is not available. This position will also be responsible for providing education and support to patients and staff regarding coding accuracy and optimization of reimbursement/RVUs.
Responsibilities:
- Assists patients with billing and insurance related matters including communicating with patients regarding balances owed and other financial issues and facilitating collection of balances owed.
- Educates patients about financial assistance opportunities, insurance coverage, treatment costs, and clinic billing policies and procedures.
- Collaborates closely with physicians and technicians to understand treatment plans and determine costs associated with these plans; Works closely with the staff on managed care and referral related issues; communicates findings to patients.
- Coordinates the pre-certification process with the clinical staff.
- Handles billing inquiries received via telephone or via written correspondence.
- Responsible for thoroughly investigating and understanding financial resources or programs that may be available to patients and educating staff and patients about these programs.
- Conducts precertification for appropriate tests or procedures and facilitates the process with managed care and the clinical team. Documents all information and authorization numbers in Epic and acts as a liaison for follow-up related to precertification.
- Performs activities and responds to patient inquiries related to billing follow-up.
- Requests necessary charge corrections.
- Identifies patterns of billing errors and works collaboratively with department manager and outside entity to improve processes as needed.
- Provides guidance regarding clinical documentation to optimize charges and RVUs
- Confirms coding accuracy based on clinical documentation and reviews common errors or misses with physicians and leadership.
- Performs administrative activities and projects as assigned.
- May perform other duties as assigned.