Perform high-volume billing data entry and complete assigned billing workflows (e.g., reporting, work queues, inventory tracking)
Review, validate, and process claims to support accurate billing and timely reimbursement
Contact insurance payors to resolve claims, denials, and billing discrepancies
Review insurance eligibility, benefits, and coverage to support accurate claim submission and prevent errors
Analyze billing issues, perform root cause analysis, and resolve denials, rejections, and discrepancies
Monitor claim status and follow up on outstanding accounts to support timely payment
Track productivity and quality metrics, including error rates, volume, and case completion
Maintain accurate documentation and ensure compliance with payer and operational requirements
Develop and update SOPs and support process improvements to enhance billing accuracy and efficiency
Train and support team members on workflows, systems, and process updates

High School Diploma or GED equivalent
3 or more years of experience in healthcare billing, revenue cycle operations, insurance claims processing, denial resolution, or payor interaction
Strong understanding of billing workflows, including eligibility and denial management
Experience with insurance claims processing and payer portal navigation (preferred)
Knowledge of Medicare, Medicaid, and commercial insurance plans (preferred)
Familiarity with revenue cycle systems (e.g., billing platforms, CRM tools) (preferred)

Billing Coordinator III

Key skills