Insurance and medical billing coordinator
heart health center provider, ajijic, jalisco, mexico
job profile: insurance and medical billing coordinator
general information:
* job title: insurance and medical billing coordinator
* department: finance / hospital administration
* reports to: revenue cycle manager or chief financial officer (cfo)
* location: hospital / clinic
job objective:
ensure the proper management of medical insurance, hospital billing, and medical coding, ensuring regulatory compliance and optimizing the insurance reimbursement process.
duties and responsibilities:
* medical insurance management:
o verify patients' insurance coverage before admission or treatment.
o coordinate with insurance companies to process claims and prevent denials.
o ensure pre-authorization of procedures when required.
* medical billing and claims processing:
o process and oversee the billing of medical and hospital services.
o identify and correct errors in invoices or claims to avoid payment delays.
o follow up on denied claims and coordinate their resolution.
* medical coding and clinical records:
o accurately apply icd, cpt, and hcpcs codes in medical bills.
o coordinate with doctors and nurses to ensure accurate medical records.
o stay updated on medical coding and billing regulations.
* regulatory compliance:
o ensure all billing processes comply with regulations such as hipaa, medicare, and medicaid.
o conduct internal audits to prevent fraud or errors in claims.
o train staff on compliance policies and best practices in billing and insurance.
job requirements:
education and certifications:
* bachelor's degree in business administration, finance, accounting, healthcare management, or a related field.
work experience:
* minimum 1 year of experience with hospital management systems and medical billing software.
skills and competencies:
* advanced knowledge of medical insurance and claims processing.
* proficiency in database management and hospital management software (e.g., epic, medisoft, cerner).
* attention to detail and analytical skills to detect billing errors.
* strong communication skills to interact with patients, insurance providers, and hospital staff.
* knowledge of healthcare regulations such as hipaa, medicare, and medicaid.
* ability to solve problems and handle multiple tasks efficiently.
working conditions:
* full-time position in a hospital or clinic setting.
* office work with frequent interaction with patients and insurance companies.
* possible internal audits and staff training sessions.
seniority level: entry level
employment type: full-time
job function: health care provider
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