Billing Coordinator

JOB SUMMARY:

Under the direction of the Billing Manager, the Billing Coordinator manages medical claim denials, ensures accurate insurance entry within the Electronic Health Records (EHR) software, assists with medical records requests and processes medical claims. Responsibilities include applying patient credits, handling patient no-shows, resolving internal tickets, and responding to patient inquiries while adhering to timely filing requirements and data standards. Additionally, the Billing Coordinator will develop expertise in payer guidelines and policies, and efficiently navigate payer portals.  

Location:

Cedar City, UT

Work Schedule:

Monday - Friday; 8:00 AM - 5:00 PM; 1 hour lunch (unpaid)

JOB FUNCTIONS:

include, but not limited to, the following:

• Process medical claims.  

• Ensures data entry standards and timely filing requirement are upheld. 
• Builds strong working relationships with external providers.  
• Coordinates with clinic managers and patient care. 
• Assists with dental billing and coding as needed. 
• Answers incoming calls related to billing. 
• Monitors fax transmission and the EHR inbox daily. 
• Reviews self-pay worklist, confirming proper attachment of sliding fee to visits and collects on outstanding balances. 
• Reviews and processes claim holds, SUU clinic claims, and front desk billing issues. 
• Facilitates billing training for new clinic employees, providing comprehensive training on billing workflows and how each role interacts and impacts the billing department. 
• Processes the billing record requests.   
• Develops a thorough understanding of payer policies and guidelines to ensure compliance and accurate claims processing. 
• Navigates payer portals efficiently to verify coverage, submit claims, and resolve billing inquiries. 
• Manages self-funded insurance for medical and prescription coverage, ensuring accurate processing and payment allocation for Tribal and Non-Tribal funds. 
• Oversees and resolves incoming billing tickets, ensuring timely responses and issue resolution. 
• Other duties as assigned to support the efficient operations of the Tribe.  

General Requirements:

• Must be insurable through the Tribe’s vehicle insurance required.
• Must pass a criminal and fingerprint background check according to P.L. 101-630 standards required.
• Must pass a pre-employment alcohol/drug screening required.

Education & Experience:

• High School diploma, equivalent GED or higher required.
• One (1) year experience processing medical billing, healthcare, or insurance data required. 
• One (1) year experience with Medicaid, Medicaid ACO’s, medical carriers, managed care, and third-party payer systems preferred. 

License & Certification:

• Must possess, maintain, and provide proof of a valid Driver’s License required.

• Group Health Care Plan (Health, Dental, Vision, Life/AD&D and Long-Term Disability). Employer paid premiums for Employee, Spouse and Dependents
• Supplemental/Voluntary Benefits (Aflac, Life/AD&D and Short-Term Disability, Hospital Indemnity, Accident, Critical Illness)
• HSA Bank Account - Monthly employer contributions
• Retirement Plan (401k, Roth) - Dollar for dollar match up to 6%
• Paid Time Off
• Paid Holidays (Federal, State and Tribal) - Paid according to set work schedule only
• Paid Birthday Leave
• Paid Bereavement Leave
• Employee Assistance Program
• Education Assistance Program
• Wellness Program - Earn up to $1,000 into your HSA account per year