NeighborHealth Center

Referral Coordinator

• Assist patients by receiving incoming referrals and coordinating referral appointments.
• Work with insurance companies and care providers to share essential patient information.
• Track and document referrals to keep staff aware of referral status.
• Ensure complete and accurate patient registration and provide necessary medical information to specialists.
• Assist patients who qualify for UNCFA to coordinate care with appropriate facilities.
• Act as a patient advocate to make sure services are given appropriately.
• Ensure timely documentation in the patient's chart regarding specialist consults and hospitalizations.

Medical Billing and Coding

• Responsible for the billing team leadership, subject matter expertise, and organizing and performing a variety of regular tasks to ensure timely and comprehensive billing and collections for services rendered by NHC providers;
• Supervise and coordinate the workload of the billing staff to ensure all tasks are completed accurately and in a timely manner.
• Define and communicate current and new billing tasks and definitions of the billing team.
• Recommend and report billing issues of concern or accommodation to the clinic manager for action.
• Run, work, and manage reports for the purpose of verifying quality and completeness of various data entry and other functions in EPIC.
• Communicate with NHC staff about missing and erroneous data and ensure the completion and correction of the same.
• Work collaboratively with other members of the organization to maximize accuracy, efficiency, and promptness of the claim life cycle.
• Troubleshoot other problems in various billing processes and document to resolution problems discovered.
• Maintain and control documentation of billing processes.
• Execute quality control processes to ensure consistent billing and collection.
• Monitor third party coverage contracts, ensuring that current contractual terms are understood and applied correctly.
• Assist accounting with reconciling EPIC monthly deposit reports to the general ledger deposits.
• Assist CFO in completion of the annual cost reports, financial audit, annual UDS report, and any other required annual governmental reporting.
• Create and foster an environment that encourages professional growth of billing specialists.
• Other duties as assigned.
• Study and evaluate new and changing billing requirements and recommend solutions.
• Work directly with managers to revise processes and resolve issues.
• Document significant billing changes and methods for management awareness.
• Monitor changing standards and methods in billing to ensure NHC methods and processes are current.
• Manage and coordinate the billing team’s work results for quality, accuracy, and timeliness.
• Oversee and review the transmission of claims in EPIC as well as other electronic and paper claim processing.
• Follow up on unpaid claims within standard billing cycle timeframe.
• Oversee payment processing for accuracy and compliance.
• Provide customer service to patients enquiring about their accounts and process requests for refunds.
• Provide ongoing orientation and training to staff.

Medical Billing Manager

Bilingual

• Scheduling appointments and managing provider templates
• Answer and manage incoming calls to the Appointment Call Queue
• Schedule various types of appointments
• Liaison between NeighborHealth and Ministry/Healthcare Partners

Scheduler, Bilingual – Spanish Speaker

Administration

• Maintain accurate and up-to-date insurance information in patient records, ensuring proper documentation and timely updates.
• Utilize Availity to research, correct, and complete payment posting aligning with EM.
• Communicate with appropriate agencies and internal contacts to obtain necessary insurance details or resolve eligibility/payment issues.
• Monitor and resolve items in all billing work queues for denials/follow up/claim Edit/credit balances and retro review.
• Run reports and follow up on bad debt.
• Assist with record keeping, sorting, and defining mail and emails.
• Assist Front Desk/Scheduling with insurance-related questions.
• Provide customer service to patients inquiring about their accounts and process requests for refunds.
• Assist with provider credentialing and payer enrollment processes, including data entry and documentation management.
• Assist and monitor Facility/Provider credentialing for renewals in coordination with Credentialing Company.
• Collaborate with internal teams to ensure smooth billing operations and support revenue cycle efficiency.
• Communicate with patients, payers, and staff as needed to resolve account-related issues.

Referral Coordinator

Medical Billing Manager

Scheduler, Bilingual – Spanish Speaker

Billing and Insurance Administrator