
Claims Processing Coordinator
17 hours ago
Key Performance Indicators (KPIs):
The ideal candidate will be measured by their ability to:
- Process claims accurately and efficiently.
- Resolve denials and rejections within established timelines.
- Secure timely reimbursements through effective follow-up and communication.
- Maintain compliance with HIPAA regulations and payer-specific psychiatry billing guidelines.
- Provide exceptional customer service and support to internal teams and providers.
Responsibilities:
- Manage the complete revenue cycle, including claim preparation and submission, denial management, AR follow-up, and payment posting.
- Ensure accurate use of CPT, ICD-10, and HCPCS codes, including psychiatry-specific codes.
- Submit electronic and paper claims to commercial insurance, Medicare, and Medicaid.
- Conduct follow-ups on pending claims and aged AR to secure timely reimbursements.
- Investigate and resolve denials and rejections, identifying root causes and resubmitting corrected claims.
- Post payments (ERA/EOB), reconcile billing records, and apply appropriate adjustments or write-offs.
- Collaborate with internal teams and providers to resolve billing discrepancies and obtain missing documentation.
Requirements:
- Intermediate/A-levels and/or Bachelor's degree in Healthcare Administration, Finance, or a related field.
- Minimum 1–2 years of hands-on experience US Medical Billing.
- Available to work night shifts aligned with U.S. Central Time.
- Solid understanding of the end-to-end RCM process specific to mental health services.
- Proficient in EMRs and billing platforms.
- Solid knowledge of psychiatry-specific billing codes, modifiers, and insurance protocols.
- Experience with insurance verification, AR analysis, denial resolution, and payment posting.
- Strong communication and documentation skills in English.
- Proficiency in MS Excel, Google Sheets, and reporting tools.
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