Billing Specialist

Suncoast Center•St. Petersburg, FL

28d

About The Position

Suncoast Center is where good changes happen. At Suncoast Center, we provide emotional wellness services to individuals and families. Our employees thrive in an environment where diversity and inclusion are a priority. Minimum Qualifications: A minimum of two years of outpatient medical revenue cycle experience is required, with preference given to candidates with behavioral health experience. The position is responsible for managing and resolving insurance denials from Medicaid, Medicare, commercial, and managed care payers. Duties include submission of electronic claims, payment posting, review and resolution of error reports, and the correction, appeal, and rebilling of outstanding insurance receivables. The role also involves verifying and obtaining insurance authorizations as required, accurately entering and maintaining patient demographic and billing information, and utilizing EHR reporting to identify and correct service issues that impact billing. Additional responsibilities include management of the billing hotline and client statements, as well as appropriate adjustment of client account ledgers. Conclusion The role of a Medical Biller is crucial in ensuring that healthcare providers are compensated for their services while maintaining clear communication with patients regarding their billing inquiries. This position requires a blend of technical skills, attention to detail, and strong communication abilities to navigate the complexities of medical billing and insurance processes.

Requirements

A minimum of two years of outpatient medical revenue cycle experience is required, with preference given to candidates with behavioral health experience.
Bachelor’s Degree in related Field with two-year of experience with Medical Billing, HIM, and/or Coding Certification is required
experience with Medical Records System
Must be 21 years of age.
Negative Drug Screening prior to hire and throughout employment.
Clear Criminal Background Check throughout employment with Suncoast Center and local checks prior to hire and annually along with DCF Level II prior to hire and as required by DCF and must have valid Florida Driver’s License Motor Vehicle checks prior to hire and annually with acceptable driving record maintained throughout employment along with reliable vehicle, valid registration, and valid vehicle insurance. (Must be in compliance with Florida Laws and Administrative Codes with fingerprinting and determined to be of good moral character).
Must be computer literate including Excel spreadsheets, electronic claims processing with 837 and 835 files, website portal navigation, EHR comprehension, Microsoft Outlook.

Nice To Haves

Netsmart AVATAR experience a plus.

Responsibilities

Submit, track, and reconcile electronic insurance claims
Post insurance payments and contractual adjustments accurately and timely
Review remittance advice and resolve payment discrepancies
Identify, correct, appeal, and rebill denied or unpaid claims for Medicaid, Medicare, commercial, and managed care payers
Verify insurance coverage and obtain required authorizations in accordance with payer requirements
Maintain accurate patient demographic, insurance, and billing information within the EHR
Utilize EHR and financial reports to identify and resolve documentation or service issues that impede billing
Coordinate with clinical and administrative staff to ensure billing accuracy and compliance
Assist the billing phone line and respond to client billing inquiries professionally and in a timely manner.
Prepare and distribute client billing statements
Perform client account and ledger adjustments in accordance with organizational policy and payer guidelines
Ensure compliance with all applicable regulatory, payer, and confidentiality requirements
Other duties as assigned