Billing Specialist II - Referral Coordinator

Job Description: Billing Specialist II - Referral Coordinator

Reports to: Senior Revenue Cycle Manager

Job Purpose:

We are a pediatric non-profit organization seeking a billing specialist to join our professional team. The billing specialist will manage all matters and communications relative to insurance claims on behalf of Texas Hearing Institute.

Position Information:                                                                          

Hours Weekly: 40

Monday – Friday: 8:00 am – 5:00 pm

Starting Salary: Determined by experience.

FLSA Status: Non-exempt

Benefits:

• Health & Dental Insurance
• Life Insurance
• Long Term Disability Insurance
• 403 (b) Retirement Plan
• 12 Paid Holidays
• 21 Paid Time Off Days  

Key Responsibilities:

Scheduling & Coordination:

• Schedule patient appointments, procedures, and follow-up visits while optimizing provider availability.
• Confirm appointments with patients and provide necessary pre-visit instructions.
• Maintain accurate and up-to-date patient records in the scheduling system.
• Coordinate rescheduling or cancellations as needed, ensuring minimal disruptions to patient care.

Prior Authorizations & Eligibility Verification:

• Submit and track prior authorization requests for medical services, procedures, and medications.
• Communicate with insurance companies to obtain approvals and resolve authorization-related issues.
• Verify patient insurance eligibility and benefits before scheduling services.
• Document authorization approvals, denials, and required follow-ups in the patient record system.
• Work closely with providers, billing, and clinical staff to ensure seamless authorization processes.

Administrative & Customer Service:

• Serve as a point of contact for patients regarding scheduling, insurance coverage, and authorization status.
• Address patient inquiries and escalate complex issues to the appropriate department.
• Maintain confidentiality and compliance with HIPAA regulations.
• Assist with other administrative duties as needed to support clinic operations.

Qualifications:

• High school diploma or equivalent required; associate’s degree or certification in medical administration preferred.
• Three-plus years previous experience in medical scheduling, prior authorizations, or insurance verification.
• Familiarity with electronic health records (EHR) and medical scheduling software.
• Strong knowledge of insurance policies, prior authorization procedures, and medical terminology.
• Excellent communication and customer service skills.
• Ability to multitask, prioritize, and work in a fast-paced environment.

Preferred Qualifications:

• Experience with IMS and insurance portals.
• Knowledge of Medicare, Medicaid, and commercial insurance requirements.
• Bilingual skills are a plus.

Tools:

·         Desktop computers

·         Laptop computers

·         iPad

·         Scanner

·         Fax machine

·         Copy Machine

·         Postage Meter

Technology:

• Internet
• Microsoft Word and Excel
• IMS (program software) – onsite training

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