BILLING SPECIALIST

Benefits Information

• Paid Time Off
• Paid Holidays
• 401(k) Matching
• Health Insurance
• Vision Insurance
• Life Insurance
• Health Savings Account
• Tuition Reimbursement
• Employee Discount
• Reduced Tuition Rates
• Disability Insurance
• Employee Assistance Program
• 401(k)
• Pet Insurance
• Dental Insurance
• Paid Training
• Flexible Spending Account

Responsibilities

• Generates all Managed Care Organization (MCO) billing and resolves unpaid claims identified on Accounts Receivable Aging and various other reports.
• Reviews and responds to all insurance billing-related correspondence.
• Provides administrative and business support in preparing, updating, and monitoring program/facility budget requirements.
• Uses coded data to produce and submit invoices to MCO.
• Ensures that claims formatting and data elements are following payer specifications.
• Works directly with MCO to get claims processed and paid.
• Researches unpaid claims, determines and corrects cause, performs collection, and follow up as needed or bills alternative payor.
• Appeals and rebills underpaid or denied claims within payer deadlines.
• Verifies patients' insurance coverage and seeks timely authorization to treat and continued stay authorizations, as needed.
• Identifies denial trends and researches the root causes to report findings to Program Director for resolution.
• Identifies denial trends and researches root causes and reports findings to supervisor for resolution.
• Aids and monitors Accounts Receivable reports.
• Prepares itemized statements, bills or invoices, recording amounts due for services rendered.
• Maintains records of invoices and supporting documents.
• Aids in posting of cash, reconciling accounts, and making authorized adjustments as needed.
• Contacts customers to obtain or relay account information.
• Composes various daily, weekly, and monthly reports as assigned.
• Performs other duties as assigned.

Qualifications

• High school diploma or equivalent and three (3) years of insurance billing experience.
• Medical coding certificate preferred.
• Ability to work with computers and the necessary software typically used by the department.
• Proficient with Excel preferred.
• Able to communicate effectively.