BILLING COORDINATOR at The Methodist Home of Kentucky, Inc. – Nicholasville, Kentucky

The Billing Coordinator is responsible for managing weekly billing processes, ensuring payments are processed accurately, and maintaining consistency in billing operations. This role collaborates with various finance and administrative staff to review services, reconcile aged accounts, and resolve payment discrepancies. Additionally, the Billing Coordinator handles insurance verification, prior authorization submissions, and keeps trackers updated to ensure eligibility and compliance for client services.

Billing Operations & Payment Processing

• Weekly Billing: Responsible for pushing out weekly billing, aiming for consistency on the same day each week.
• Service Review: Removes non-billable services (e.g., IL Therapy) from billing
• Cash & Credit Card Payments: Processes and secures cash payments accurately. Manages Skybank and credit card payments, monitors associated fees, and coordinates with finance to resolve discrepancies.
• Aged Accounts: Documents and tracks aged accounts, working closely with Finance to reconcile these to the general ledger.
• Load Sliding Scale discounts into the pay source for clients
• Send out client balance statements

Insurance Verification & Prior Authorizations (PAs)

• Insurance Coverage: Verifies insurance coverage for all clients, including commercial and Medicaid plans. Uses Welligent and other systems for eligibility checks and follows up on inactive or problematic cases.
• PA Submission: Submits prior authorizations for services, ensuring all required documentation is gathered.
• Tracker Management: Keep PA Tracker up to date at all times with accurate PA status, dates, and notes
• Monitor communications and Provider Portal for PA status updates

Denials, Non-Payments & Appeals

• Denials Management: Serves as the primary point of contact for all denials and non-payments, dedicating significant time to resolving these issues. Documents and communicates outcomes to relevant parties.
• Appeals & Peer-to-Peer: Coordinates appeals and peer-to-peer reviews for denied claims, ensuring all necessary documentation is provided and deadlines are met.

Requirements

• Able to physically perform CPR and First Aid.
• Able to navigate buildings on campus
• Must be at least 21 years old and have a minimum of 1 to 3 years of experience.
• Must be able to submit and pass State and Federal background checks.
• High school diploma or equivalent; preferred Bachelor Degree.