Billing Specialist

About the role

A Partner in Wellbeing, the Billing Specialist comprehensively supports Alluma’s behavioral health revenue cycle operations. This position requires data analysis, in-depth evaluation, and sound judgement.

Responsibilities

• Claim Processing
  • Prepare, review, and submit claims to various payers.
  • Identify and bill secondary or tertiary insurances.
  • Work in conjunction with the access team to ensure clean billing.
  • Balance daily batches and reports.
  • Resubmit claims to insurance companies as necessary.
  • Review insurance payment for accuracy and compliance with contract discount.
  • Review electronic explanation of benefits from the insurance company, post the contractual obligation, the client liability, and payment received to the client’s account.
  • Post insurance payment within the Electronic Health Record (EHR) accurately and timely.
  • Contact insurance companies regarding payment discrepancies on moderately complex payment variances.
  • Ensure claim timely filing deadlines are achieved.
• Denials
  • Investigate, resolve, and respond to behavioral health insurance claim denials involving research, analysis, and problem-solving.
  • Research and appeal denied claims.
  • Generate retractions or voids upon resolution of denied claims.
• Client Invoicing
  • Generate reports and review to ensure accuracy of client statements.
  • Review client bills for accuracy and completeness.
  • Obtain missing client information and update client records.
  • Identify and resolve client billing complaints.
  • Answer client and/or insurance inquiries.
• Support the Billing Coordinator in resolving complex or escalated issues by researching information and proposing and/or developing effective solutions.
• Work on special projects that increase efficiencies, improve workflows, and resolve issues which deliver positive financial impact.
• Coordinate cross-functionally to aid with coding and credentialing questions.
• Administer routine maintenance and standard EHR functions.

Qualifications

• Associate degree in accounting, finance, medical coding, or related field preferred.
• 3+ years of experience in healthcare billing preferred.
• Must pass criminal background check through MN DHS NetStudy.
• Access to a personal vehicle and the ability and willingness to use the vehicle to carry out position responsibilities.
• Valid driver’s license and insurable under the agency’s automobile insurance policy.
• Free from substance use problems for a period of no less than 2 years.