Billing Specialist

Job Summary: Provides timely billing, follow-up, and final resolution of assigned accounts. Ensures appropriate contractual adjustment is taken on account. Research remittance advice to determine accurate payment levels are made by payers. Responsibilities: Professional, Patient, and People-First Attitude. All interactions will be customer service oriented. This includes verbal, email, text, or written communications. Review of claim entries for coding accuracy prior to submitting claims for payment. Backup to data entry of billing transactions. Completes various billing edit reports and corrects. Goal of 100 percent clean claims File primary, secondary, and tertiary claims to ensure maximum entitled reimbursement. Read and interpret insurance explanation of benefits. Posting of copayments and insurance payments. Research and correct unpaid claims within timely filing guidelines for payers. Call insurance companies to resolve billing issues. Follow up on denials. Meet with Billing Manager to discuss and resolve reimbursement issues or billing obstacles. Assists with Special Projects and other duties as assigned by Manager. Meets weekly and/or individual and team targets. Job Qualifications: Knowledge: Managed Care Organization (MCO) and Medicaid. Behavioral health billing preferred. Experienced in CPT, ICD-10 coding, and medical terminology. Education: High School Diploma/GED Required Skills: Minimum of 3 years in full revenue cycle billing. Computer literate and problem-solving mind set. Well organized and detail oriented. Ability to handle multiple tasks. Must be able to work independently as well as part of a team. Disciplined and self-motivated to work from home. Experience: Three or more years of experience in healthcare billing & collection practices, working with Medicaid/Medicare and commercial insurance billing. Behavioral Health/Outpatient billing experience preferred. Credentialing knowledge helpful. Netsmart experience preferred. Technical/Computer Skills:Skilled in operating various medical record software and hardware, word-processing, and database software programs; minimum of 50 WPM preferred. Core Competencies: Ability to learn and appropriately apply basic medical terminologies and techniques taught and used on the job. Strong written and verbal communication skills. Keyboard proficiency (approximately 50 words/minute). Ability to operate a personal computer and related software applications. Strong attention to detail. Ability to multitask and accept Billing Manager or Director of Revenue Cycle Managment prioritization of job duties. Ability to problem solve under pressure. Ability to communicate and interact professionally with others. Understanding of and commitment to appropriate protection of confidential patient information. Must be able to have a HIPAA secure work from home environment when telecommuting. Physical Requirements: Ability to view computer monitors with close vision, color vision, depth perception, and ability to adjust your focus with good hand-eye coordination. Ability to operate a computer and/or laptop through proficient typing, clicking, and viewing a monitor for extended periods. Employee must be able to sit up to 90% of the time. Employee must be able to stand, walk, and climb stairs (up to 10% of the time)(if an elevator is unavailable). Must be able to frequently (up to 20% of the time) listen and speak clearly in person, and via telephone. Other Work Requirements: Expected Hours of work – Full Time. Monday through Friday 08:30 AM to 05:00 PM. . The job duties listed in this job description may not be inclusive of all requirements of this position. Other duties may be assigned based on management discretion.