Billing Specialist

• Collaborate closely with medical professionals, insurance payers, specialists, and other healthcare stakeholders to ensure seamless care coordination for our members.
• Day-to-day member communications - managing member questions & feedback, and resolving member concerns (chat & phone support)
• The Billing Coordinator acts as a single point-of-contact to coordinate resources along the care delivery spectrum, identify gaps, and provide proactive follow-up
• This role is responsible for responding to customer questions via telephone and written correspondence regarding their insurance claims.
• Navigates through complex billing workflows to understand patient’s next steps and clearly communicates to patient and internal team members next steps for the patients
• Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments and following up with patients when payment lapses occur.
• Examining patient bills for accuracy and requesting any missing information for proper claims processing.
• Coordinates with other resources and providers to ensure smooth continuum of care for patients and becomes a subject matter expert in some of the care coordination workflows (billing)
• Ensure if we cannot answer the members' needs that we connect them immediately to someone who can i.e. urgent needs, clinical needs, etc.
• Ability to exercise considerable judgment and discretion in establishing and maintaining strong partnering relationships with members
• Suggests changes to leadership in an effective way to improve workflows for self and others.
• Manage coordination of care within Tia’s ecosystem, working cross-functionally across different teams to ensure members needs are met.
• Clearly document all communications and contacts with providers and personnel in standardized documentation and messaging.
• Cross trained on additional parts of the care coordination department with a focus on first contact resolution and creating a seamless experience for patients
• Learns complex workflows for Tia services - regarding billing, claims and insurance practices
• Tech troubleshooting

Billing Coordinator

Manager

• Oversee a team of care coordinators, ensuring exceptional member interactions, optimizing processes, and maintaining high-quality service delivery.
• Ensure efficient communication between patients, healthcare providers, and internal teams while upholding industry regulations and best practices.
• Collaborate closely with medical professionals (RNs, NPs, MDs), specialists, and other healthcare stakeholders to ensure seamless care coordination for members.
• Monitor the progress of member journeys, identify potential barriers, and implement strategies to optimize member health outcomes.
• Provide effective leadership, guidance, mentoring, and performance feedback to care coordination representatives.
• Manage complex member cases and escalated issues, providing timely resolutions and guidance in alignment with company policies and protocols.
• Implement and refine standard operating procedures and workflows for the contact center to ensure efficient handling of member requests and inquiries.
• Utilize data to evaluate contact center performance, member feedback, and operational metrics; identify trends and provide recommendations for improvement.
• Collaborate with various teams outside of Care Coordination, including medical teams, billing, enrollment, and product, to ensure effective communication and knowledge sharing.
• Provide formal coaching, feedback, and support to direct reports; lead onboarding of new teammates and ongoing training; contribute to the team's formal knowledge base.
• Regularly assess performance metrics and conduct root cause analyses in partnership with Quality and Training specialist to drive improvements.
• Help gather and share insights gained from member interactions to drive improvements in products, services, and overall member experience.

Billing Coordinator

Associate Manager, Care Coordination