Medicaid Billing Specialist

Alternatives, Inc•Aurora, IL

About The Position

Alternatives is a Behavioral Health Clinic (BHC) and Substance Use Prevention (SUD) organization. We bill a state contract for SUD services and Medicaid/MCO’s for both the BHC and SUD services. The Billing Specialist will be responsible for ensuring timely and accurate billing for both services. The Billing Specialist will be responsible for correcting billing errors, tracking appeals and rejections and maintaining an 80% collection rate. The Billing Specialist will work collaboratively with the Clinical team and the Finance team to monitor the medicaid revenue cycle.

Requirements

Medical Billing Certification or 3+ years of Medicaid Billing experience
Experience with Qualifacts/Insync required
Proficiency with Innovalon and Availity
Proficiency with Google Workspace & Microsoft
Strong organizational skills that reflect excellent attention to detail.
Strong knowledge of CPT and ICD-10 coding

Nice To Haves

Experience with DARTS Preferred

Responsibilities

Perform the following from a racial, gender, sexuality, and ability equity lens:
Submit billing claims that are timely and accurate with correct CPT/ICD10 codes, modifiers, units and amounts.
Resolve rejections/denials on a routine and timely basis
Post and reconcile payments
Monitor and follow up on outstanding AR
Collaborate with the Clinical Team to ensure accurate coding
Communicate with Clinical Supervisors regarding documentation and coding clarification
Ensure compliance with payer guidelines, Medicaid and HIPAA regulations
Use the finance accounting software to track receivables
Act as a liaison between the Finance Department the Clinical team
Maintain a collection rate of at least 80%
Provide monthly billing report updates to Executive Team
Upload DARTS admissions and discharges
Bill DARTS accurately and and timely