Billing Coordinator

Overview

The Billing Coordinator is responsible for initiating contact with various payers to resolve outstanding claims for services provided by FirstHealth of the Carolinas. This role ensures full and timely reimbursement in accordance with current government and payer regulations. The Billing Coordinator plays a critical role in maintaining accounts receivable by promptly pursuing unsettled insurance accounts in alignment with organizational policies, procedures, and productivity standards.

🔹 About FirstHealth of the Carolinas:
FirstHealth of the Carolinas is a private, not-for-profit health care network headquartered in Pinehurst, North Carolina. With a mission to care for people, FirstHealth is committed to delivering high-quality, patient-centered care through a comprehensive range of services including hospitals, outpatient centers, and home care. The organization is recognized for its innovation, excellence in clinical care, and dedication to community health.

Responsibilities

• Initiate and maintain communication with insurance payers to resolve outstanding claims.
• Ensure accurate and timely follow-up on unpaid or denied claims.
• Interpret and apply payer-specific billing guidelines and government regulations.
• Maintain detailed documentation of all billing activities and payer communications.
• Collaborate with internal departments to resolve billing discrepancies and ensure accurate claim submissions.
• Monitor and manage accounts receivable for assigned payers to meet departmental goals.
• Utilize EPIC software to track, update, and manage claim status and patient account information.
• Ensure compliance with HIPAA and other regulatory requirements in all billing activities.
• Meet or exceed productivity and quality standards as defined by department leadership.

Qualifications

Education:

• High school diploma or equivalent – required
• Associate degree – preferred

Experience:

• 3–5 years of medical billing or reimbursement experience in a hospital or medical office – preferred
• Experience specifically in Home Health and Hospice billing – preferred

Preferred Skills:

• Proficiency in EPIC software
• Knowledge of HIPPS, CPT, and ICD-10 coding
• Understanding of insurance reimbursement guidelines
• Excellent interpersonal, written, and verbal communication skills
• Strong organizational and time management abilities
• Proficiency in Microsoft Office Suite, especially Excel, Word, and Outlook

Education:

• High school diploma or equivalent – required
• Associate degree – preferred

Experience:

• 3–5 years of medical billing or reimbursement experience in a hospital or medical office – preferred
• Experience specifically in Home Health and Hospice billing – preferred

Preferred Skills:

• Proficiency in EPIC software
• Knowledge of HIPPS, CPT, and ICD-10 coding
• Understanding of insurance reimbursement guidelines
• Excellent interpersonal, written, and verbal communication skills
• Strong organizational and time management abilities
• Proficiency in Microsoft Office Suite, especially Excel, Word, and Outlook
• Initiate and maintain communication with insurance payers to resolve outstanding claims.
• Ensure accurate and timely follow-up on unpaid or denied claims.
• Interpret and apply payer-specific billing guidelines and government regulations.
• Maintain detailed documentation of all billing activities and payer communications.
• Collaborate with internal departments to resolve billing discrepancies and ensure accurate claim submissions.
• Monitor and manage accounts receivable for assigned payers to meet departmental goals.
• Utilize EPIC software to track, update, and manage claim status and patient account information.
• Ensure compliance with HIPAA and other regulatory requirements in all billing activities.
• Meet or exceed productivity and quality standards as defined by department leadership.