Job Description

Insurance Coordinator
Job Title: Insurance Coordinator
Department: Billing & Administration
Reports To: Clinic Manager / Office Administrator
Summary:
The Insurance Coordinator manages all aspects of the medical billing process related to insurance. They ensure accurate and timely submission of claims, follow up on outstanding accounts, and assist patients with their insurance-related queries.
Key Responsibilities:

• Claims Processing: Prepare, review, and submit electronic and paper claims to various insurance companies.
• Verification & Authorization: Verify patient insurance eligibility and benefits prior to appointments. Obtain pre-authorizations and referrals for procedures as required.
• Payment Posting: Post insurance payments and adjustments to patient accounts in the billing system.
• Denial Management: Investigate and resolve claim denials or rejections. Submit appeals when necessary.
• Patient Assistance: Answer patient questions regarding insurance coverage, explain benefits, and help patients understand their financial responsibility (co-pays, deductibles, co-insurance).
• Compliance: Stay updated on coding changes (CPT, ICD-10) and insurance regulations to ensure compliance.

Qualifications & Skills:

• High school diploma or equivalent (required); certification in Medical Billing & Coding (highly preferred).
• Minimum of 2 years of experience in a medical billing or insurance coordination role.
• In-depth knowledge of medical terminology, insurance guidelines, and billing procedures.
• Proficiency in medical billing software and EMR systems.
• Strong attention to detail and analytical problem-solving skills.
• Excellent communication skills for interacting with insurance companies and patients.

Skills Required