Billing Coordinator

Mohawk Valley Health System; City of Utica (NY); On-site; USD 28,000 - 39,000; Full time

Job summary

The Billing Coordinator at Mohawk Valley Health System in Utica, NY coordinates insurance authorizations, supports medical billing, and ensures timely access to patient care by obtaining required approvals for medications, procedures, and imaging.

You will liaise with providers, patients, insurance companies, and pharmacies, document activity in EPIC, educate patients on insurance requirements and financial responsibilities, and assist with denial follow-up and appeals as needed.

Qualifications

• High school diploma or equivalent.
• 4+ years of relevant healthcare billing experience.
• Strong organizational, communication, and problem-solving skills.
• Knowledge of medical terminology and payer guidelines.
• HIPAA compliance and confidentiality.

Responsibilities

• Obtain and coordinate prior authorizations for specialty medications per payer requirements.
• Coordinate insurance authorizations for diagnostic tests and imaging studies.
• Verify patient insurance eligibility, benefits, and coverage.
• Communicate with insurance companies, pharmacies, hospitals, and offices about status.
• Document authorization activity accurately in EPIC and related systems.
• Educate patients on insurance requirements and financial responsibilities.
• Assist with medical billing, including claim review, denial follow-up, and appeals.

Skills

Prior authorization

Insurance knowledge

Communication skills

Customer service

Multitasking

Education

High school diploma

Job description

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The Billing Coordinator is responsible for coordinating insurance authorizations, supporting the medical billing process, and ensuring timely access to patient care by obtaining required approvals for medications, procedures, diagnostic testing, and imaging studies. This position serves as a liaison between providers, patients, insurance companies, pharmacies, and healthcare facilities to ensure authorizations and billing-related processes are completed accurately and efficiently.

Core Job Responsibilities

• Obtain and coordinate prior authorizations for specialty medications, including high-cost injectable and chemotherapy medications, in accordance with payer requirements.
• Coordinate insurance authorizations for diagnostic testing, imaging studies, procedures, and other services requiring payer approval.
• Verify patient insurance eligibility, benefits, and coverage to ensure authorization and billing accuracy.
• Communicate with insurance companies, specialty pharmacies, hospitals, imaging centers, and physician offices regarding authorization requirements and claim status.
• Collaborate with providers, nursing staff, and clinical teams to obtain necessary clinical documentation supporting authorization requests prior to scheduled services when appropriate.
• Document all authorization activity, payer communications, and patient interactions accurately within the electronic medical record (EPIC) and applicable systems.
• Educate patients regarding insurance requirements, authorization status, financial responsibilities, and next steps in the treatment process.
• Assist with medical billing functions, including claim review, denial follow-up, appeals, and resolution of billing issues as assigned.
• Maintain current knowledge of payer guidelines, authorization requirements, and regulatory changes affecting reimbursement.
• Ensure compliance with HIPAA, payer regulations, and organizational policies regarding patient confidentiality and documentation.
• Prioritize workload effectively while managing multiple authorizations, billing tasks, and deadlines simultaneously.
• Participate in departmental meetings, trainings, and quality improvement initiatives.
• Processing forms and faxes in alignment with department standards..
• Perform other duties as required.

Education/Experience Requirements

REQUIRED:

• High school diploma or equivalent.
• 4+ years of relevant experience in a healthcare setting.
• Demonstrated ability to prioritize work and communicate effectively.
• Demonstrated strong organizational and communication skills, excellent customer service, attention to detail, and the ability to manage multiple priorities in a fast-paced medical office.
• Knowledge of medical terminology, insurance regulations, prior authorization processes, and medical billing practices.
• Strong organizational, analytical, and problem-solving skills.

PREFERRED:

• Experience with insurance company rules and regulations preferred, Medical Terminology strongly recommended.
• Working knowledge of insurance plans, prior authorization processes, Medicare, Medicaid, and commercial payer requirements.

Disclaimer

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.
Successful candidates might be required to undergo a background verification with an external vendor.

Pay Range $20.00 - $28.00 Per Hour