Billing Specialist I

About the Role

As a member of the Finance team, the Billing Specialist will be accountable for the claim balance of specifically assigned accounts. This role reports directly to the Contracts and Billing Supervisor.

Responsibilities

• Process timely and accurate authorizations for patient services.
• Ensure claims are processed timely and with correct data points.
• Support identification of issues and implementation of corrective actions/process changes.
• Manage the Accounts Receivable aging to ensure outstanding balances are rectified in a timely manner.
• Identify basis for denied claims, develop and communicate internal and/or external corrective actions, and resubmit claims where appropriate.
• Apply payments to clients’ accounts in a timely manner adhering to the month-end cutoffs.
• Develop client statements and, upon clinician request, communicate client balance in a timely manner.
• Complete billing audits as required.
• Participate in ad-hoc projects related to billings, collections, or denials.
• Participate in billing and/or intake-related meetings as necessary and offer advice/perspective as it relates to billings and authorizations.

Requirements

• Coding certification.
• Experience with Electronic Health Record systems.
• Billing Clearinghouse knowledge.
• Experience calling or inquiring electronically with insurance companies to assess claim status.
• Knowledge of diagnosis, billing codes, and modifiers.
• Understanding of accounts receivable aging.

Skills

• Advanced knowledge of coding, modifier usage, and denial reason codes.
• Proficient in Microsoft Office applications, especially Excel.
• Proficient in web-based insurance portals and billing clearinghouses.
• Proficient in electronic health systems.
• High level of verbal and written communication skills.
• Strong organizational skills and attention to detail.
• Ability to maintain confidentiality of sensitive information and documents.
• Proven ability to prioritize responsibilities to ensure timely completion.

Other Requirements

• DHS Background Check Approval.
• Successful completion of Drug Test upon hire.
• Documentation of Tuberculin test and/or evaluation with negative results or evidence of non-communicability.

Working Conditions

This position has the potential to work remotely after the initial 90 days and upon supervisor approval.