Billing Coordinator

Job Description

Job Description

Description:

Summary/Objective: The Billing Coordinator plays a key role in supporting both the financial and clinical performance of our medical practice. This position ensures that daily patient charges are accurately reviewed and ready for submission to the Central Billing Office (CBO), while also managing quality metrics and gaps in care to optimize performance under value-based care programs.

This individual serves as a vital link between clinical staff, billing teams, and management—helping to maintain compliance, streamline workflows, and enhance patient outcomes through accurate documentation and proactive quality initiatives.

Essential Functions: (This list may include but is not limited to the following assigned duties)

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Billing and Charge Review

• Review and verify all daily provider charges for accuracy, completeness, and appropriate coding before submission to the Central Billing Office.
• Collaborate with providers and staff to resolve discrepancies or missing documentation in a timely manner.
• Ensure compliance with billing and documentation standards, payer requirements, and coding guidelines.
• Monitor and track charge submission timelines to prevent billing delays.
• Assist with communication between the Central Billing Office and the front office check-in staff regarding billing questions, rejected claims, or coding clarifications.
• Track and follow up on patient balances ensuring timely payment.

Quality and Value-Based Care Coordination

• Monitor and track quality metrics, performance measures, and patient care gaps as defined by payer programs.
• Work with providers and care teams to identify patients needing follow-up for preventive care, chronic disease management, or missing quality elements.
• Support documentation improvement initiatives to ensure accurate reporting of care delivered.
• Prepare reports and dashboards related to quality performance, patient outreach, and incentive program progress.
• Coordinate with leadership on strategies to improve outcomes and maximize value-based payment opportunities.

Administrative and Collaborative Functions

• Serve as liaison between clinical, administrative, and billing departments.
• Participate in team meetings to discuss workflow improvements, billing updates, and quality performance.
• Maintain confidentiality and compliance with HIPAA and organizational policies.

Required Competencies (Knowledge, Skills and Abilities):

The requirements listed below are representative of the knowledge, skills and abilities required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Strong understanding of CPT, ICD-10, and modifier usage.
• Familiarity with payer quality programs and healthcare reporting measures.
• Proficiency with electronic health records (EHR) and billing systems.
• Excellent attention to detail, analytical skills, and problem-solving abilities.
• Strong communication and teamwork skills.
• Ability to multitask and prioritize in a busy clinical environment.

Required Education and Experience:

• High school diploma or equivalent required; associate or bachelor’s degree in healthcare administration, billing, or related field preferred.
• Minimum 2 years of experience in medical office billing, coding, or revenue cycle management preferred.
• Experience working with quality measures or value-based care initiatives strongly preferred.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit; walk; stand, use hands to finger, handle or feel; and reach with hands and arms.

Environmental/Working Conditions:

• Work is performed in a busy office environment and requires both desk and counter work.
• Frequent contact with employees and outside agencies.
• Continual patient contact may involve dealing with angry or frustrated patients.

Benefits Available:

• Multiple medical and prescription coverage options
• Dental and vision care plans
• Health Savings Accounts (HSAs), where applicable
• Flexible Spending Accounts (FSAs)
• Voluntary critical illness, cancer, and accident insurance
• Voluntary hospital indemnity coverage
• Voluntary short-term and long-term disability insurance
• Voluntary term life insurance and AD&D (Accidental Death & Dismemberment)
• 401(k) retirement savings plan
• Paid time off (PTO)
• Commuter benefits
• Group auto and homeowners insurance

Part-time Benefits:

• Vision
• Flexible Spending Accounts
• MetLife Auto/Vehicle & Home Insurance Discounts