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Healthcare Billing & Insurance Coordinator
CQ Partners. Verify patient eligibility, benefits, and coverage before services are rendered .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare billing, insurance verification, and claims processing, with a strong focus on compliance with Medicare, Medicaid, and HIPAA regulations. Proficient in managing accounts receivable and improving reimbursement outcomes through effective communication and problem-solving.
Highest-signal resume keywords
Healthcare Billing ExperienceInsurance VerificationClaims ProcessingPayer Portal ProficiencyRegulatory Compliance Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims SubmissionAccounts Receivable ManagementInsurance AuthorizationData AnalysisReport GenerationPayment ReconciliationDenial ManagementProcess ImprovementAttention to DetailTime Management
Soft Skills
Strong Communication SkillsCustomer Service SkillsOrganizational SkillsProblem-Solving SkillsTeam Collaboration
Tools & Technologies
Microsoft ExcelMicrosoft WordHealthcare Software SystemsPayer Portals
Industry Keywords
Revenue Cycle ManagementMedical Billing RegulationsPayer RequirementsHIPAA ComplianceTPA Guidelines
About the role
Key responsibilities & impact- Verify patient eligibility, benefits, and coverage before services are rendered
- Identify authorization requirements, coverage limitations, deductibles, coinsurance, and copays
- Review and understand TPA requirements and guidelines
- Communicate benefit information and insurance requirements to providers and staff
- Assist front office teams with insurance-related questions
- Maintain accurate insurance information in the patient management system
- Monitor payer policy changes and reimbursement requirements
- Prepare, review, and submit clean claims accurately and timely
- Monitor claim acceptance and resolve submission errors
- Follow up on unpaid or pending claims
- Research and resolve claim processing issues
- Investigate denied claims and payment discrepancies
- Submit corrected claims, reconsiderations, and appeals
- Identify denial trends and recommend process improvements
- Post insurance and patient payments
- Reconcile account balances, adjustments, and payment variances
- Manage aging reports and outstanding balances
- Follow up on underpayments and unpaid claims
- Support collection and reimbursement goals
- Maintain relationships with insurance carriers and payer representatives
- Stay informed of payer policies and reimbursement updates
- Maintain compliance with Medicare, Medicaid, commercial payer requirements, HIPAA regulations, and company policies
- Assist with audits, reporting, and quality assurance initiatives
- Support the patient journey from insurance verification through final payment collection
- Collaborate with providers, administrative staff, and team lead to improve operational efficiency and reimbursement outcomes
- Participate in process improvement initiatives and special projects
Requirements
What you’ll need- High school diploma or equivalent
- Strong organizational, communication, and customer service skills
- Ability to manage multiple priorities in a fast-paced environment
- High attention to detail and accuracy
- Moderate to strong proficiency in Microsoft Excel and Microsoft Word, including creating, maintaining, and analyzing spreadsheets, generating reports, and preparing professional business documents
- Minimum of 2 years of healthcare billing, insurance verification, revenue cycle, or medical office experience (preferred)
- Experience working with insurance carriers, payer portals, and healthcare billing systems (preferred)
- Knowledge of insurance verification, authorizations, claims processing, appeals, denials, and accounts receivable management (preferred)
- Strong analytical and problem-solving skills
- Ability to work independently and as part of a team
- Strong written and verbal communication skills
- Effective time management and organization
- Knowledge of medical billing regulations and payer requirements
- Proficiency with healthcare software systems and payer portals
Benefits
Comp & perks- Competitive hourly pay
- Paid time off
- Paid holidays
- Health insurance
- Dental insurance
- Vision insurance
- Life insurance
- 401(k)
- Professional development opportunities
- Remote work with periodic office meetings