Medical Billing Specialist

The Recovery Village•Weston, FL

10h•Remote

About The Position

Advanced Recovery Systems is an integrated behavioral healthcare management company dedicated to the treatment of addiction, substance abuse, and mental health issues. They provide assistance to people with substance abuse issues, addictions and mental health concerns, with facilities in various regions of the U.S. The company strives to provide the highest quality of care, using evidence-based therapeutic models. The AR Specialist will be required to complete Audits, Compiles and Create Claims for submission. They will respond timely to address up front and backend rejections, working each claim billed until payment is received or deemed uncollectable.

Requirements

High School and GED required.
Minimum of 3 years of experience in medical business matters at an Acute Hospital Organization, Physician practice, Behavioral Health Facility, or Medical Billing Company.
Employee to utilize their own personal computer, meeting expectations of the company's software and virus security standards.
Windows 11 w/ latest Windows update installed. (Chromebooks and Apple computers are not compatible.)
An “up to date” antivirus software.
Stable internet connection.
Distraction-free environment.
Functional webcam.
Present yourself professionally during all video interactions—this includes dressing in appropriate, work-ready attire.
State & Federal Statutes Regarding Patient Confidentiality laws; Drug-Free Workplace Policies; Workplace Violence; Corporate Integrity& Compliance Program.
Customer and Personal Service.
Mathematics.
Education and Training.
Clerical.
Computers and Electronics.
Reporting.
Active listening.
Speaking.
Coordination.
Social Perceptiveness.
Critical Thinking.
Judgment and Decision Making.
Monitoring.
Reading Comprehension.
Deductive Reasoning.
Inductive Reasoning.
Written and Oral Expression.
Problem Sensitivity.
Written and Oral Comprehension.
Speech Clarity and Recognition.
Ability to work as part of a multidisciplinary team.
Ability to communicate accurately and concisely, written and oral.
Excellent interpersonal and telephone skills.
Effective financial assistance in charge, billing capture and collection efforts to clients in treatment or transitioned/discharged.

Nice To Haves

Associates Degree Preferred.
Lean Six Sigma, Kaizen or other Lean Process Management experience a preferred asset.
CPC, CPAT, or CPAM preferred.

Responsibilities

Ability to work virtually in a remote capacity, adhering to set working schedule with periodic contact with management throughout the day via phone or via teams.
Daily auditing of active and non-active clients to ensure proper program, authorization, diagnosis, and revenue elements have been captured.
Communicating with department and hospital staff to address any issues related to billing and the accuracy of charge capture, insurance, authorization and billing.
Addressing all rejected claims, merging, editing and ensuring proper filing is done in accordance with ARS’ billing rules.
Ensuring all worklists assigned by management are up to date and compliant in terms of productivity and accuracy.
Updating EMR and patient accounts when required, and opening IT tickets to address any issues that may cause delay in billing.
Following up post submission for any third-party billing to ensure claim(s) are on file and set to pay.
Resolving claims issues in which the payer has rejected the claim; by filing corrective claims, filing claim level appeals, providing additional information to the payer to support the claim, or advancing the claim(s) to the next level – UR appeal and/or Management.
Documenting actions throughout the claim life cycle by entering notes within Avatar, Waystar, and BB Tech (Tool Kit).
Identify claim rejection and denial trends, and bringing those trends to the attention of management.
Attend AR meeting as needed and conducted by your management team.
Apply standard improvement processes, follow-through (PDCA); Plan, Do, Check and Action.
Maintain strict confidentiality, adhere to Part2 regulations and HIPAA guidelines.
Follow all state regulations and adhere to all company policies and procedures.
Other duties as assigned.