Billing Specialist

Job Description

Job Description

Description :

The Billing Specialist will be responsible for credentialing, shared billing tasks, and overseeing authorizations. Billing Specialist is responsible for all claims submissions, collections, and payment postings in a timely manner.

Responsible for follow-up with third-party payers and clients. Also responsible for keeping A / R to a minimum as set forth in established goals.

Additional tasks in full job description.

Essential Duties and Responsibilities :

• Perform job tasks on-site
• Develops and implements billing processes, policies and procedures in collaboration with VPO and Leadership Team.
• Documents and creates SOPs for all Billing processes for training.
• Collects and verifies all patient insurance information needed to complete the billing process on a monthly basis.
• Completes all necessary insurance forms, schedules peer reviews, and other tasks needed to process claims in a timely manner as required by all third-party payers.
• Daily reconciliation of sessions to ensure all sessions have been converted and authorizations correctly linked.
• Works with Practice Managers to ensure notes are converted, billing entries are accurate and completed in a timely manner for submission.
• Transmits daily all electronic claims to third-party payers. Researches and resolves any electronic claim delays within 24 hours.
• Proactively follows up on pending claims within a few days of submitting.
• Submits any paper claims and supporting documentation as required by payers.
• Resolves patient complaints and requests regarding insurance billing in a courteous manner, initiates accurate account adjustment / pmt arrangements.
• Follows all billing problems to conclusion. Submits secondary and tertiary insurances.
• Follows up on denials and resubmits insurance claims as required.
• Maintains confidentiality in regard to patient account status and the financial affairs of the clinic as required by HIPAA and signed confidentiality agreement.
• Communicates effectively to payers and / or claims clearinghouse to ensure accurate and timely electronically filed claims as per department guidelines.
• Responsible for monthly billing cycle / patient statements.
• Reconciles with administration for month end.
• Follows all guidelines as set forth by HIPAA.
• Credentialing and Authorizations as needed.
• Trains and supervises billing staff
• Organizes and maintains order and cleanliness of Billing
• Record retention as required by law.
• Generates reports and delivers to VPO as requested

Requirements :

Additional Skills and Abilities :

• Knowledge of office procedures.
• Ability to speak clearly and concisely. Ability to read, understand, and follow oral and written instruction.
• Basic medical terminology.
• Ability to interpret an EOB and knowledge of computerized billing systems.
• Ability to develop goals, prioritize, organize and make most efficient use of time.
• Ability to communicate with patients in a courteous yet stern manner to collect on delinquent accounts.
• Ability to use individual judgement to solve problems and make decisions.

Education and / or Experience :

Requires 2 years minimum experience in an ABA or 5 years in a medical business office setting.

Qualifications :

Familiarity with CentralReach, and / or ABA, SLP or OT billing.

Certificates, Licenses, Registration :

Billing / Coding certification a plus.

Requirements :

• Candidates must be available to work on-site, as this is not a remote position
30+ days ago