Billing Specialist

About the role

Suncoast Center is seeking a Medical Biller to join our team. We provide emotional wellness services and prioritize diversity and inclusion in our environment. The ideal candidate will manage and resolve insurance denials from various payers, ensuring accurate billing and timely payments.

Responsibilities

• Submit, track, and reconcile electronic insurance claims
• Post insurance payments and contractual adjustments accurately and timely
• Review remittance advice and resolve payment discrepancies
• Identify, correct, appeal, and rebill denied or unpaid claims for Medicaid, Medicare, commercial, and managed care payers
• Verify insurance coverage and obtain required authorizations in accordance with payer requirements
• Maintain accurate patient demographic, insurance, and billing information within the EHR
• Utilize EHR and financial reports to identify and resolve documentation or service issues that impede billing
• Cookline the billing hotline and client statements
• Aid the billing phone line and respond to client billing inquiries professionally and in a timely manner
• Prepare and distribute client billing statements
• Perform client account and ledger adjustments in accordance with organizational policy and payer guidelines
• Ensure compliance with all applicable regulatory, payer, and confidentiality requirements

Requirements

• A minimum of one year of outpatient medical revenue cycle experience, with preference given to candidates with behavioral health experience
• Bachelor's degree preferred and Medical Billing, HIM, and/or Coding Certification required
• One year of experience, working Medicare, Medicaid and third party outpatient insurance claims and denials utilizing an EHR; or a two-year degree in Medical Billing, HIM, or a Billing/Coding certification required
• Knowledge of ICD-10CM, CPT and HCPCS
• Prefer experience in Behavioral Health Billing
• Must be 21 years of age
• Negative Drug Screening prior to hire and throughout employment
• Criminal Background Check throughout employment with Suncoast Center and local checks prior to hire and annually along with DCF Level II prior to hire and as required by DCF
• Valid Florida Driver’s License, Motor Vehicle checks prior to hire and annually with acceptable driving record maintained throughout employment
• Reliable vehicle, valid registration, and valid vehicle insurance
• Computer Literate: Must be computer literate including Excel spreadsheets, electronic claims processing with 837 and 835 files, website portal navigation, EHR comprehension, Microsoft Outlook. Netsmart AVATAR experience a plus

Qualifications

• Education: Bachelor's degree preferred and Medical Billing, HIM, or a Billing/Coding certification required

Skills

• Technical skills in medical billing and insurance processes
• Attention to detail and strong communication abilities
• Ability to function as a team player and maintain professional relationships
• Compliance with equal employment opportunity and ethical standards

Benefits & Perks

• Health & Wellness: Medical, dental, and vision insurance with 0% copay for Teledoc Appointments, Employee Assistance Program (EAP)
• Work-Life Balance: Paid time off + 10 company-paid holidays
• Growth & Development: Professional development options through our Learning Management System and live trainings
• Other Perks: 403(b) with up to a 5% company match, Monthly Social Committee Events

Pay

Competitive salary based on experience and qualifications

Schedule

Variable work schedule according to department demands