Billing Coordinator

Job Overview:

Under the supervision of the department Manager, the Billing Coordinator will manage claims processing specifically for pre-transplant procedures and ensure accurate billing using the Electronic Medical Record (EMR) hospital and provider claim work queues. Responsibilities will include, but are not limited to reviewing, approving, and processing claims, conducting high-level analysis on reimbursement and claims management to optimize revenue cycle performance, as well as resolving patient and provider complaints.

Qualifications:

Required:

• Bachelor s degree in healthcare administration, finance, or a related field
• Proven experience in medical billing and claims processing, preferably in a healthcare setting
• In-depth knowledge of medical billing, coding, and reimbursement methodologies
• Strong analytical skills and attention to detail, with the ability to interpret complex data
• Excellent communication and interpersonal skills to collaborate effectively with various stakeholders
• Familiarity with Epic or similar electronic health record systems is highly desirable
• Ability to work independently and prioritize tasks in a fast-paced environment

Scheduling Requirements

• Shift: Day (Monday-Friday - no weekends)
• Time: 800am 4:00pm
• Status: Full-Time

Essential Functions:

Claims Processing:

• Review and validate claims for accuracy and completeness in compliance with transplant billing policies and insurance requirements.
• Utilize EMR work queues to process, track, and resolve all hospital and provider claims in a timely manner.

Approval and Review:

• Approve claims based on thorough review and analysis, ensuring all necessary documentation is complete.
• Edit and resubmit claims as needed, coordinating with relevant departments to resolve any discrepancies.
• Communicate with patients and providers to quickly resolve any billing concerns or issues.

High-Level Analysis:

• Conduct analyses of reimbursement trends and claims management practices to identify opportunities for improvement.
• Prepare detailed reports on claims performance, reimbursement rates, and denials, providing insights to management.

Collaboration:

• Work closely with the clinical and administrative teams to ensure accurate documentation supports the billing process.
• Liaise with patients, providers, insurance payers and other external stakeholders to resolve claims issues quickly and efficiently.
• Facilitate and maintain relationships through regular, pro-active communication, and timely follow-through on requests.
• Resolves patient complaints

Compliance:

• Stay current with regulatory changes and payer requirements, ensuring all procedures comply with industry standards and best practices.
• Assist in audits and implement corrective actions as necessary.

Other Responsibilities:

• Train/Consult physician and staff on proper billing and coding workflows.
• Participate in ongoing professional development to enhance skills and knowledge in billing and reimbursement.

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short- & Long-Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

Equal Opportunity Employer