Billing Specialist

Meadows of Wickenburg•Boynton Beach, FL

12d

About The Position

The Billing Specialist enters patient demographic information into the billing software and submits billable claims to insurance companies. Before submitting claims, the specialist cross-checks the medical EMR for authorization and verifies through the insurer’s portal that the client’s policy is active. The role also involves filing corrected claims, resolving rejected claims, and updating the action list for Utilization Review issues identified during billing. The specialist promotes the organization’s mission, values, and vision; provides excellent customer service while following HIPAA confidentiality and privacy protocols; researches insurance plans and shares pre-certification and policy information with the Utilization Review team; and works with Utilization Review Specialists to support high levels of care. The position ensures applicable insurance standards and regulations are met and includes other duties as required.

Requirements

High school diploma or GED equivalent, with a combination of education and work experience.
Minimum of two years’ 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, 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 demographic information into billing software.
Enter and submit billable claims to insurance companies.
Check the medical EMR for authorization and verify that client insurance policies are active before submitting claims.
File corrected claims and resolve rejected claims.
Update the action list for Utilization Review issues encountered during billing.
Promote the organization’s mission, values, and vision.
Provide excellent customer service and comply with HIPAA confidentiality and privacy protocols.
Research insurance plans and provide the Utilization Review team with pre-certification and policy information.
Work with Utilization Review Specialists to support the highest levels of care for clients.
Ensure required insurance standards and regulations are met.
Perform other duties as required.