Billing Specialist

Family Service•San Antonio, TX

50d•$16 - $22

About The Position

The Billing Specialist performs clerical, billing procedures, and administrative tasks to optimize client and customer experience in the day-to-day operations of the business or program office to which they are assigned while ensuring that services provided are in alignment with the Social Determinants of Health through a trauma informed care lens as defined by the agency.

Requirements

Professionalism and Ethics: The demonstration of ethics and sound professional practices, as well as stimulation social accountability and community stewardship. The desire to act in a way that is consistent with one's values and what one says is important.
Financial Skills: Ability to understand and explain financial accounting information, prepare and manage budgets.
Critical Thinking and Analysis: The ability to assess the authenticity, accuracy and worth of knowledge claims, beliefs, or arguments and reaching sound conclusions based on observation and information.
Performance Measurement: The ability to understand and use statistical, economic, epidemiological and financial methods and metrics to set goals and measure clinical as well as organizational performance; commitment to and employment of evidence-based techniques.
Healthcare and Human Services Environments: Ability to explain issues and advancements in the healthcare and human services industries.
High school diploma.
1-2 years of medical billing, and behavioral health billing, or healthcare revenue cycle experience.
Basic understanding of medical billing and coding process.
Knowledge of insurance verification, claims submission, payment posting, denials, and accounts receivable follow-up.
Familiarity with HIPAA regulations and confidentiality requirements.
Proficiency in Microsoft Office applications, particularly Excel, Word, and Outlook.

Nice To Haves

Experience working with Medicaid, Medicare, commercial insurance, and managed care organizations preferred.
Experience in a nonprofit healthcare or behavioral health setting preferred.
Understanding of behavioral health documentation and billing requirements preferred.
Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Accounting, Finance, or a related field.
Twoo (2) or more years of experience in behavioral health, mental health, substance use treatment, or nonprofit healthcare billing.
Experience billing Medicaid, Medicare, managed care organizations, and commercial insurance plans.
Knowledge of behavioral health billing regulations, authorization requirements, and documentation standards.
Experience with Electronic Health Record (EHR) systems and practice management software.
Bilingual in English and Spanish preferred.
Ability to work independently while maintaining effective collaboration with clinical, administrative, and finance terms.

Responsibilities

Verify client insurance eligibility, benefits, and authorization requirements prior to service.
Review clinical documentation to ensure completeness and compliance with billing requirements.
Prepare, submit, and track claims to Medicaid, Medicare, managed care organizations, and commercial insurance carriers.
Monitor claim status and follow up on unpaid, denied, or rejected claims in a timely manner.
Research and resolve billing discrepancies, claim denials, and payment issues.
Post insurance and client payments accurately and reconcile billing records.
Maintain accurate client demographic, insurance, and billing information within the Electronic Health Record (EHR) and billing systems.
Generate and review billing, accounts receivable, and reimbursement reports.
Communicate with insurance companies, clients, and staff regarding billing inquiries and payment issues.
Collaborate with clinicians and program staff to ensure documentation supports billing and reimbursement requirements.
Assist with audits, compliance reviews, and reporting requirements as needed.
Maintain confidentiality of client information in accordance with HIPAA and organizational policies.
Stay informed of changes in billing regulations, payer requirements, and reimbursement guidelines.
Assigned Front Desk (Suite 103) lunch coverage, desk coverage