Accounts Receivable Billing Specialist

Essential Duties

• Timely billing submission of electronic and paper claims to payers.
• Resolves billing edits related to coding, charging, and other billing issues.
• Creates monthly client billing invoices to payers who do not accept UB-04 or 1500 billing.
• Timely follow-up on claims and payment status.
• Follow-up on denials for outstanding accounts and submitting appeals when necessary to maximize collections where possible.
• Ensure that all past-due client accounts are researched and resolved, utilizing payer portals for benefit verification, claims, and payment status.
• Ensure the proper order of filing claims to primary, secondary, and tertiary payers, moving balances to client responsibility after other payer sources are exhausted.
• Receive and respond to phone calls and correspondence with questions and requests for information from customers (internal and external).
• Work collaboratively with other staff, clients and/or external third-party payors in a courteous, timely, and accurate manner.
• Serve as direct back-up support to peers.
• Maintain regular and consistent attendance.
• Meet defined department goals for productivity, AR days and other Key Performance Indicators.
• Promote, support, and demonstrate SHP’s mission, vision, and values through both behavior and job performance and adhere to policies, procedures, Compliance Plan and Standards of Conduct on a day-to-day basis.
• Effectively interact and communicate with other SHP staff/clients/customers/partners/etc.
• Perform other duties as assigned.

Job Requirements

• Detail oriented, with high-level problem solving, analytical, and investigational skills.
• Ability to work well independently, as well as in a team setting.
• Excellent written and verbal communication skills.
• Problem-solving and organizational skills.
• Proficient in Microsoft Office (Outlook, Word, Excel, and Power Point).
• Knowledge of CPT and ICD-10 codes, medical terminologies, billing software, and electronic medical records.
• Understanding of industry-specific policies, such as HIPAA regulations for health care.

Qualifications

• High school diploma or completion of G.E.D. required.
• More than two years of experience in healthcare billing or similar billing of third-party payor claims required.
• Experience working in nonprofit organizations and/or healthcare organizations preferred.
• Equivalent combination of education and experience may be evaluated and considered.
• Preferred Associate’s degree or two-year college certificate in business administration, medical billing or related field preferred.
• Experience working with Colorado Medicaid will be an advantage.
• EPIC experience a plus.
• Preferable associate degree in business, medical billing or related field, or equivalent experience in healthcare/medical insurance environment.
• Previous mental health experience preferred but not required.
• Bilingual/bi-cultural preferred.
• Some positions include driving a company vehicle and require a valid Colorado driver’s license.

Benefits

• Medical, dental, and vision coverage — including options for eligible dependents.
• Mental health and wellness resources.
• Short-term and long-term disability insurances.
• Paid time off (PTO): Accrued vacation and personal leave based on FTE status and length of service.
• Paid Sick Leave: Provided in accordance with the Colorado Healthy Families and Workplaces Act (HFWA).
• A range of voluntary benefits available to all employees.
• 403(b) retirement plan with employer matching contributions.

Total Rewards

• Reach Out SummitStone will provide persons with disabilities with reasonable accommodations.
• If reasonable accommodation is needed to participate in the job application or selection process, please let your recruiter know.
• Questions? Please email us at hiring@summitstonehealth.org.

Equal Opportunity Employer

We are committed to fostering a diverse and inclusive environment where everyone can be their authentic self. We actively seek team members with a variety of backgrounds, identities, and experiences, and we honor the whole self—embracing differences in race, ethnicity, ability, age, gender, sexual orientation, spiritual beliefs, socioeconomic status, language, and the many intersections of identity. We invite everyone to be part of our journey and proudly serve as an equal opportunity employer.