Billing Specialist

Phoenix Group Home, LLCSalt Lake City, UT

About The Position

The Billing Specialist plays a pivotal role at Path Behavioral Healthcare. As a Biller, you'll ensure timely and accurate billing operations, helping families navigate their healthcare finances with ease. Our aim? To create a transparent and efficient billing system, reinforcing our commitment to the community and promoting trust, clarity, and peace of mind. BLOODBORNE PATHOGEN CATEGORY I: Tasks with actual blood/body fluid exposure are not included in this position’s duties as the job requires therapeutic counseling only.

Requirements

  • Candidate must have a high school diploma or GED.
  • A minimum of two years of experience in a medical office setting and at least one year in medical billing and billing software.
  • Strong familiarity with Medicaid and insurance web portals and knowledge of the life cycle of claims.
  • This position requires the ability to work under stressful conditions and to work irregular hours.
  • Requires sitting for extended periods of time, viewing computer monitors, and keyboarding.
  • Must have excellent verbal and written communication skills to communicate professionally via telephone and in writing.
  • Strong grammar and writing skills are crucial for clear and concise communication with clients, colleagues, and other healthcare professionals.
  • The successful candidate must demonstrate the ability to interact and assist in a friendly, compassionate, and professional manner with colleagues, providers, clients, and their families, as they represent both themselves and Path Behavioral Healthcare.
  • Candidates must achieve competency in the Electronic Health Record (EHR) program, telemedicine services, and any added software programs used by the company, ensuring efficient access, and updating of client information.
  • The role requires fine dexterity, adept handling, and proficient gripping abilities to perform various tasks.
  • The candidate must pass all federal and state background checks, and their educational and work history will be confirmed in compliance with company policies.

Responsibilities

  • Review patient bills for accuracy and completeness and obtain any missing information.
  • Prepare, review, andtransmitclaims using billing software, including electronic and paper claim processing.
  • Assistwith payroll close bi-weekly as needed
  • Assistwith daily Failed Activities and Failed Claims as needed
  • Follow up on unpaid claims within the standard billing cycletime frame.
  • Call insurance companiesregardingany discrepancy in payments if necessary,Identifyingand billing secondary or tertiary insurances.
  • Review accounts for insurance of patient follow-up. Researching and appealing denied claims.
  • Submit claims to the clearinghouse (Medicaid and Medicaid Managed Care),fix rejections as needed.
  • Work on denied claim(s) and rebill when necessary.
  • Uphold strict adherence to HIPAA guidelines, confidentiality protocols, billing and coding standards, and company policies.
  • Respect and uphold cultural diversity, religious, and personal values of clients and their families in alignment with the agency's mission.
  • Exhibit a positive professional demeanor and serve as an exemplary representative of Path Behavioral Healthcare's mission and vision.
  • Collaborate effectively with all Path Behavioral Healthcare employees,demonstratinga clear understanding and adherence to organizational processes and policies.
  • Take onadditionaltasks or responsibilities as assigned by the Operations Team and Billing Manager.
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