Billing Specialist Jobs

About The Position

Requirements

• Minimum of high school diploma or equivalent.
• Minimum of one year of successful experience in a similar position.
• Ability to communicate effectively and professionally with a wide variety of people.
• Strong organizational skills with attention to detail and accuracy.
• Basic computer skills which includes a working knowledge of databases, word processing, spreadsheets, and Internet software.
• Ability to handle multiple tasks in a very busy environment.
• Ability to defuse escalated situations while maintaining excellent customer service.
• Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations.
• Ability to add, subtract, multiply, divide, in all units of measure using whole numbers, common fractions, and decimals.
• Ability to apply common sense understanding to carry out detailed, but uninvolved, written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.

Nice To Haves

• Knowledge of and experience in medical billing preferred.

Responsibilities

• Verifies individual client’s private insurance and Medicaid for Admissions in order to provide parents/guardians with payment estimates prior to scheduling appointments.
• Completes prior authorization requests for private insurance clients and maintains them, as required.
• Uses private insurance and Medicaid verifications to set up all payor sources in applicable billing system to ensure that billing is submitted to the correct primary, secondary, and tertiary payor sources. Updates and maintains client information upon notification of changes. If there are changes to individual accounts which affect ACCESS’s ability to bill for services, Accounts Receivable Supervisor should be notified immediately.
• Submits Medicaid bulk eligibility requests in deTaso at the beginning of each week. Places billing on hold for clients that are determined to be ineligible. Contacts parents regarding status of Medicaid and monitors status. Keeps Accounts Receivable Supervisor apprised of status.
• Processes medical records requests from insurance companies.
• Works partial payments and denials in both systems. Coordinates with Clinical Services Coordinator (CSC) to determine status of therapy prior authorizations. Researches classroom, therapy, and AERC denials and partial payments. Works with Waiver Department to obtain needed prior authorizations or to work through problems. Recommends and submits write offs to Accounts Receivable Supervisor for review and approval.
• Prints, reviews, and mails monthly statements. Discusses any accounts with larger than typical or questionable balances with Accounts Receivable Supervisor prior to mailing.
• Files and maintains paperwork related to billing records, including insurance Explanations of Benefits (EOB), Remittance Advices (RA), etc.
• Completes relevant and approved in-service trainings.
• May perform other related and non-related duties, as assigned.