Accounts Receivable & Medical Billing Specialist

Wingspan Care Group•Shaker Heights, OH

9d•$45,000 - $55,000

About The Position

Under the direct supervision of the Director of A/R, the Medical Billing Specialist is responsible for processing timely, complete and accurate billing information in compliance with government and third party payers to insure prompt and accurate reimbursement.

Requirements

3-5 years related experience and/or training required.
Demonstrated accounts receivable and collection skills.
Possess skill, knowledge and abilities to perform the essential duties of their role; keeps knowledge up to date.
Demonstrate ability to perform job responsibilities with a high degree of initiative and independent judgment.
Demonstrate awareness, sensitivity and skills in working professionally with diverse individuals, groups and communities who represent various cultural and personal background and characteristics.
Communicate clearly using verbal, nonverbal, and written skills in a professional context; demonstrates clear understanding and use of professional language.
Adhere to professional values such as honesty, personal responsibility, and accountability; Applies ethical concepts within scope of work and adheres to Agency policies and procedures.
Function effectively as a member of a professional team that includes employees, clients and family members.
Recognize problems and responds appropriately; gathers information and sorts through it to identify and address root cause issues; makes timely decisions.
Anticipate, recognize, and meet the needs of others, whether they are clients or not.
Demonstrate competence in utilizing Agency computer systems and software as required to perform essential job functions.

Nice To Haves

Associates Degree preferred.
Medical coding certification preferred

Responsibilities

Prepare, review and process healthcare claims to the clearinghouse for the Managed Care Organizations (MCOs), Medicaid, Medicare and commercial insurance companies using billing software.
Entering claims using CPT, ICD-10 codes and other medical terminology.
Meet coding deadlines to expedite the billing process.
Review all insurance payments for accuracy and compliance with the contract discount.
Following up on unpaid claims within the standard billing cycle.
Identify, research, resolve and/or appeal denials, exceptions and exclusions.
Manage patient and insurance inquires.
Maintain records of medical billing.
Validate eligibility, benefits, deductibles and produces accurate documentation.
Assist in the development and implementation of operational improvements.
Continuously learn about healthcare coverage options and benefit plans.
Communicate with management of payer trends identified.
Enter payment posting and adjustments.
Contribute to the development and maintenance of the Agency’s systems through the timely completion of assigned documentation and in accordance with applicable legal, fiscal, licensing and accreditation regulations and standards.
Maintain current knowledge and skills through reading and utilizing coding resources.
Attends and participates in coding education systems.
Respect the privacy of clients. All client material should be handled in accordance with Agency guidelines on confidential material.
Ad-hoc analysis and reporting as necessary.
Other duties as assigned by management.

Benefits

Comprehensive health and Rx plans, including a zero-cost option.
Wellness program including free preventative care
Generous paid time off and holidays
50% tuition reduction at Case Western Reserve University for the MNO and MSW programs
Defined benefit pension plan
403(b) retirement plan
Pet insurance
Employer paid life insurance and long-term disability
Employee Assistance Program
Support for continuing education and credential renewal
Ancillary benefits including: dental, vision, voluntary life, short term disability, hospital indemnity, accident, critical illness
Flexible Spending Account for Health and Dependent Care