Billing Coordinator New - Los Angeles California

Company: Tbwa Chiat/Day Inc
Location: Los Angeles, California
Posted On: 11/21/2024

As a Tia Billing Coordinator, you will be every Tia member's partner in their health and wellness journey-helping them navigate both the healthcare system, billing/claims, and ensuring that they are getting a concierge-level experience at Tia. In this position, you will be responsible for a variety of tasks requiring data analysis, in-depth evaluation, and sound judgment. To succeed in this role, you must possess in-depth knowledge of healthcare billing software and medical insurance policies. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as communicating with patients and various insurance payers will form a large part of the job. You'll also partner with cross-functional teams across the company to empower providers to focus on members' care and support overall business needs.ESSENTIAL FUNCTIONSMember Billing Coordination: Collaborate closely with medical professionals, insurance payers, specialists, and other healthcare stakeholders to ensure seamless care coordination for our members.

• Day-to-day member communications: managing member questions & feedback, and resolving member concerns (chat & phone support).
• The Billing Coordinator acts as a single point-of-contact to coordinate resources along the care delivery spectrum, identify gaps, and provide proactive follow-up.
• This role is responsible for responding to customer questions via telephone and written correspondence regarding their insurance claims.
• Navigates through complex billing workflows to understand the patient's next steps and clearly communicates to patient and internal team members next steps for the patients.
• Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments and following up with patients when payment lapses occur.
• Examining patient bills for accuracy and requesting any missing information for proper claims processing.
• Coordinates with other resources and providers to ensure smooth continuum of care for patients and becomes a subject matter expert in some of the care coordination workflows (billing).
• Ensure if we cannot answer the members' needs that we connect them immediately to someone who can, i.e. urgent needs, clinical needs, etc.
• Ability to exercise considerable judgment and discretion in establishing and maintaining strong partnering relationships with members.
• Suggests changes to leadership in an effective way to improve workflows for self and others.Manage coordination of care within Tia's ecosystem, working cross-functionally across different teams to ensure members' needs are met.
  • Clearly document all communications and contacts with providers and personnel in standardized documentation and messaging.
  • Cross-trained on additional parts of the care coordination department with a focus on first contact resolution and creating a seamless experience for patients.
  • Learns complex workflows for Tia services regarding billing, claims, and insurance practices.
  • Tech troubleshooting.
  • High school diploma or equivalent required.
  • Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency
  • 2-4 years of experience in a healthcare billing/claims or related field.
  • Comfortable with a fast-paced environment and frequent change and energized by metrics.
  • Understanding of healthcare billing and insurance practices, medical terminology, and member engagement in a healthcare context.
  • Should possess excellent communication, teamwork and management skills, be empathetic but resolute in your decision-making, and be attentive to detail.
  • Knowledge in using contact center software, member relationship management (CRM) systems, claims/billing systems, and/or Google Workspace.
  • Excellent problem-solving skills and the ability to remain composed in high-pressure situations.
  • Solution-oriented: Will seek answers to your questions, whether through SOPs or through other team members or leadership.
  • Adherence to strict confidentiality standards and understanding of healthcare data privacy regulations, such as HIPAA.
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