Billing Specialist I

Spectrum Health & Human Services•Orchard Park, NY

13d•$17 - $22•Onsite

About The Position

Spectrum Health & Human Services partners with adults, children, and families recovering from behavioral, emotional, mental health, and/or substance-related disorders, offering individualized opportunities for hope, empowerment, and support. The Billing Specialist I organizes, coordinates, and monitors billing functions under the direction of the Accounts Receivable Manager. The role coordinates communications among team members and internal and external vendors and maintains client accounts and payer activity in the electronic health record system. This is a full-time, on-site position at 227 Thorn Ave, Orchard Park, New York. Compensation is $17.46–$22.26 per hour.

Requirements

High school diploma or equivalent.
One year of work-related experience is preferred.
Valid driver's license with an acceptable driving record.
Excellent verbal and written interpersonal and communication skills.
Organizational skills and the ability to make contacts and establish relationships to obtain information needed for the program to function within the larger system.
Meticulous documentation and recording skills, attention to detail, time management, and organizational skills.
Ability to handle multiple tasks.
Proficiency with computer software such as MS Word, Excel, PowerPoint, and Outlook.
Ability to operate office equipment.

Nice To Haves

One year of work-related experience.

Responsibilities

Perform authorization verification, obtain required information, and address problems.
Work with site office staff to keep insurance information, procedures, and policies current and ensure they are followed.
Enter financial information into the electronic health record system within 48 hours and verify its accuracy.
Verify demographic information for accuracy.
Ensure appropriate clinical staff are assigned based on insurance restrictions and notify site Directors of potential case transfers.
Verify and enter insurance and private-fee data, including authorizations when required.
Ensure regulatory policies and procedures are followed based on current guidelines.
Track and verify receipt of new-client financial data at administration within 48 hours of the assessment visit.
Work with site office staff to correct information deficiencies and address problems.
Monitor fee-for-service billing for regulatory compliance and adherence to agency submission timeframes.
Process claims at least biweekly by generating claim batches.
Edit claims accurately for successful submission and payment.
Submit 837 files and verify 277 acceptance of file uploads.
Review pended and denied claims for resubmission or follow-up with insurance representatives.
Process private-fee monthly statements no later than one workday after fiscal closing; schedule work to accommodate this process.
Report inaccuracies related to coding, pricing, authorizations, and other matters to the Accounts Receivable Manager for programming into Cerner software.
Follow the Code of Ethics and report concerns or violations to management staff and/or the Compliance Officer.
Operate office machines and instruct others in their operation.
Work on site as required by departmental policies.
Perform other duties as assigned.