Billing Specialist

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.

Maintains the enrollment activities and coordinates, reviews, and processes billing-related activities for Balance Autism’s Speech and Occupational Therapy programs. The Billing Specialist uses set guidelines, best practices, and works towards the objectives established by the Operations Director.

• Assist in the admission process for Balance Autism families interested in SLP, OT services.
• Establish and maintain billing systems for all funding related to speech and occupational therapy which may include commercial insurance, Medicaid funding and private pay funding.
• Collaborate with service teams to ensure service authorizations are received and correctly maintained in the billing software program for persons served.
• Constantly contribute to improving processes and resolving issues related to service billing by facilitating billing processes with standardized practices and assisting with accounting and customer service.
• Review and follow up on all processes regarding billing and past due account balances to maximize collection and detect any remaining errors in the accounts receivable aging schedules.
• Verify charges, procedure codes, and diagnosis codes utilizing appropriate modifiers and diagnosis digits.
• Prepare and submit monthly or weekly claims to the correct payers within a specified timeline for primary and secondary payers. May prepare monthly invoices for families and other pay sources. May make recommendations for adjustments and write-offs of non-collectible accounts.
• Perform various collection actions, including contacting patients and third-party payers.
• Review and assist in appealing unpaid claims and help resolve payment discrepancies. Works aged accounts to ensure reimbursement.
• Participate in the design and implementation of new accounting procedures and processes for new and existing programs.
• Assist to establish and maintain systems that allow Balance Autism to access insurance funding, including credentialing the agency and applicable Speech Language Therapists and Occupational Therapists.
• Review account receivables monthly and adjudicate past due claims for all funding sources to align with billing documentation exceeding 60 days old.
• Contact members monthly to obtain payments or relay account information.
• Collaborate with service teams to ensure monthly billing is completed by deadlines.
• Participate in the development and reporting of metrics data as assigned.
• Other duties as assigned.

• Coding certification and/or associate’s degree in related field, or equivalent combination of education and experience.
• Knowledge of various computer software, insurance billing software, and financial software.
• Knowledge of disability services.
• Outstanding written and oral communication skills.
• Understanding of medical terminology and coding preferred.
• Preferred:
  Bachelor’s degree with related experience in the medical field with at least one year of experience.

• Must be able to sit, talk, and hear.
• Frequently required to use hands to finger, handle, or feel.
• Occasionally required to stand and walk.
• Occasionally lift and/or move up to 10 lbs.
• Specific vision abilities required by this job include close vision and ability to adjust focus.
• The noise level in the work environment is usually moderate.

Balance Autism is an equal opportunity employer.

Benefits:
Medical insurance, Vision insurance, 401(k), Student loan assistance, Tuition assistance.

Seniority Level: Entry level

Employment Type:

Full-time

Job Function:
Business Development

Industries:
Mental Health Care and Non-profit Organizations