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The Billing Specialist is responsible for a variety of duties, as assigned by supervisor, which may include routine billing payment posting and problem solving for various payers, including insurance, HMO, Medicaid, Medicare and private pay. The Billing Specialist may be responsible for obtaining and entry of prior authorizations. This position is responsible for clear, detailed communication with the clinical and billing staffs and with payers and clients regarding various insurance-related and payment-related issues. Performs related work as required.
Knowledge, Skills and Abilities:
Knowledge of medical billing procedures, practices and protocols; must have excellent oral and written communication skills; must be able to problem solve; must be able to operate independently in the absence of supervisor; ability to meet changing demands and exhibits a high degree of professionalism and communicates effectively; demonstrated ability to meet deadlines; demonstrated ability to professionally approach and interact with all levels of staff, and other agencies and the public; ability to abide with the agency’s professional code of ethics; must be detailed and deadline oriented; working skill in following established procedures; working skill in preparing financial or statistical reports; some skill in reading and understanding job related documents; skill in maintaining confidentiality of information and materials; good knowledge of basic mathematics.
Responsibilities:
- Adhere to agency policies and procedures.
- Verify correct client payers and properly update EHR.
- Prepare, review, and transmit client claims in a timely manner using billing software including electronic and paper claim processing.
- Conducts appropriate research for any denied claim and corrects, rebills or initiates appeals within the designated timeframes.
- Retrieves 835’s, EOB’s and electronic files as required for payment posting.
- Post and balance claim payments in a timely manner.
- Provide summary of daily financial transactions to supervisor before close of business each day.
- Stay informed of updates, changes and on-going issues with all payer sources.
- Prepare and accurately/systematically maintain a variety of organizational records and files.
- Processes a wide variety of complex records, reports, applications, and other transactions as required.
- Verifies that internal checks and balances are operating efficiently to maintain internal control.
- Makes recommendations for modifications in office forms and procedures.
- Performs other related duties as assigned.
Qualifications:
Minimum qualifications include a high school diploma and/or GED and 3 to 5 years’ experience in data entry and/or processing billing. Excellent attention to detail required. Experience working in a Behavioral health setting and experience in Carelogic systems preferred.
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- IRA plan with employer match
- 10 paid Holidays
Weekly schedule: Monday to Friday Work Location: In person
Empowered for Excellence provides equal employment opportunities to all employees and applicants for employment regardless of race, color, age, sex, creed, national origin, economic status, sexual orientation, or physical disability. In addition to federal law requirements, Empowered for Excellence complies with applicable state and local governing nondiscrimination in employment in every location in which the agency has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.