Billing Specialist

Meadows of Wickenburg Inc•Boynton Beach, FL

14d•Onsite

About The Position

The Billing Specialist enters patient demographics into billing software and prepares and submits billable claims to insurance companies. Before submitting claims, the specialist checks the medical EMR for authorizations and verifies that client insurance policies are active through insurer portals. The role also involves filing corrected claims, resolving rejected claims, and updating the action list for Utilization Review issues during billing. The specialist researches insurance plans and shares pre-certification and policy information with the Utilization Review team, working with Utilization Review Specialists to support appropriate levels of care. The role requires adherence to insurance standards and regulations, confidentiality and HIPAA privacy protocols, and excellent client service. Other duties may be assigned.

Requirements

High school diploma or GED equivalent, with a combination of education and work experience.
Minimum of two years of experience in substance abuse or mental health medical billing and coding.
Knowledge of third-party payers and billing requirements for in-network and out-of-network providers.
Knowledge of substance abuse treatment.
Proficiency with relevant computer software and hardware applications, including Word, Excel, PowerPoint, Outlook, electronic medical records, billing systems, and/or scheduling applications.
Strong written and verbal communication skills.
Ability to work independently and as part of a team.
Ability to manage multiple tasks and set priorities.
Ability to handle highly sensitive and confidential information.
Ability to work in a fast-paced, high-energy environment.
Excellent interpersonal and customer-facing skills.
Accuracy and attention to detail.

Nice To Haves

Bachelor’s degree.
Experience with KIPU.

Responsibilities

Enter patient demographics into billing software.
Enter and submit billable claims to insurance companies.
Check the medical EMR to ensure authorization is on file before submitting claims.
Verify that client insurance policies are active through insurer portals before submitting claims.
File corrected claims and resolve rejected claims.
Update the action list for Utilization Review issues during billing.
Promote the organization’s mission, values, and vision.
Provide excellent customer service while following confidentiality and HIPAA privacy protocols.
Research insurance plans and provide the Utilization Review team with pre-certification and policy details.
Work with Utilization Review Specialists to achieve the highest levels of care for clients.
Ensure required insurance standards and regulations are met.
Perform other duties as required.