Billing and Claims Patient Coordinator

$31,200 - $35,360/Yr

PEDIATRIC CARDIOLOGY CONSULTANTS OF SOUTH TEXAS - Northeast Side, TX

Full-time - Entry Level

Northeast Side, TX

About the position

The Front Desk Patient Coordinator at Pediatric Cardiology Consultants of South Texas serves as the first point of contact for patients, managing both administrative and financial aspects of patient visits. This role emphasizes excellent customer service, efficient patient check-in/check-out, and the processing of referrals and insurance claims. The ideal candidate will be detail-oriented, ensuring accurate management of patient accounts and timely processing of claims and payments.

Responsibilities

• Greet patients warmly and ensure a positive and professional experience.
• Manage patient check-in and check-out processes efficiently.
• Schedule patient appointments and follow-ups based on physician availability and patient needs.
• Process referrals to specialists and ensure all required documentation is provided.
• Maintain the reception area, keeping it clean, organized, and welcoming.
• Update and maintain patient demographics by collecting personal and financial information.
• Verify insurance coverage and confirm eligibility prior to patient appointments.
• Explain insurance coverage to patients, including out-of-pocket costs, co-pays, and deductibles.
• Collect outstanding balances, co-pays, deductibles, and previous balances as needed.
• Manage billing processes and send claims to insurance companies.
• Handle prior authorizations and ensure all required documentation is submitted accurately.
• Communicate with insurance payers to ensure timely processing of claims and resolution of issues.
• Post charges, collections, and payments into the computer system and close daily batches.
• Monitor and follow up on unpaid claims, denials, or payment discrepancies to ensure timely reimbursement.
• Provide patients with detailed explanations of their bills, including procedures not covered by insurance.
• Answer incoming phone calls, manage emails, and respond to patient inquiries regarding appointments, billing, or general clinic information.
• Assist in coordinating care with physicians, nurses, and other clinic staff.
• Ensure all patient documentation is completed accurately and filed appropriately.
• Participate in daily, weekly, or monthly meetings to review clinic operations, billing, and patient satisfaction metrics.

Requirements

• High school diploma or equivalent; additional education in healthcare administration or billing is a plus.
• Experience in a medical front office role.
• Proficiency with billing and claims management.
• Strong understanding of insurance verification, prior authorizations, and claims processing.
• Excellent communication and interpersonal skills with a patient-centric approach.
• Strong organizational skills and attention to detail.
• Ability to handle confidential information with professionalism.