Billing Specialist

Description

Reports to:

Billing Supervisor

The agency Billing Specialist will be a full-time, goal-oriented, revenue driven, highly accurate and motivated biller. Primary duties will include consistent follow-up on unpaid claims and denials, utilize monthly aging reports and filing appeals when appropriate to obtain maximum reimbursement.

• Manage accurate and timely filing and follow-up of primary and secondary claims.
• Review of all explanation of benefits to identify any denials.
• Answer phone calls and take payments as needed from consumers.
• Post consumer and insurance payments (including electronic posting).
• Interpret insurance explanation of benefits.
• Submit Invoices outside the Agency.
• Submit Claims
• Work on invalid and rejected claims within the Clearinghouse.
• Manage insurance aging and all issues related to insurance denials.
• Run any necessary reports including any month end reports for monthly closing.
• Maintain an awareness of ongoing or upcoming billing issues and assist to resolve issues as they arise.
• Timely response to inquiries from insurance companies, consumers, and providers.
• Have a strong understanding of insurance companies, covered codes, required documentation for payment.
• Ensures that patient records are accurate and complete with respect to verification and authorization of insurance, and that patient-confidentiality is strictly maintained.
• Create two separate AR’s, Comcare AR and Comcare CCBHC. Follow up on returned reports, adjustments, and denials.
• Work with Auditor’s for yearly visits.
• Work daily voids for Outpatient and Comcare
• Check denial batch report from Pixx file, send email to appropriate staff on any overlapping claims for correction. Follow up regarding claim resubmission and voids.
• Post Comcare payments, along with cash recoupments provided by Comcare’s payment back up. Run a report for payment information and purchase order request for our accounting team. File ACH notifications for future use.
• Follow up with MHA and Comcare staff pertaining to batch errors.
• Consult Sedgwick County desktop to ensure timely billing for the agency.
• Work Comcare weekly Spend down report from Comcare efficiently.
• Work Comcare denial spreadsheet, send email to appropriate staff, make any adjustments.
• Perform additional duties as requested by Supervisory or Management team.

• Maintain acceptable overall attendance record, to include department staff meetings, agency meetings, and training as required. Ensures appropriate notification to supervisor for absences and ensures that work is covered.
• Exhibit appropriate level of technical knowledge for the position.
• Work well with a team, keep others informed of information needed. Treat others with respect.
• Maintain effective and professional verbal and written interactions with peers, consumers, supervisors, and other staff. Use diplomacy and tact in dealing with difficult situations or people. Demonstrate effective listening skills.
• Demonstrate the ability and willingness to handle new assignments, changes in procedures and business requirements. Identify what needs to be done and take appropriate action.
• Complete assigned work, meet deadlines without reminders and follow-up from supervisor or others.
• Perform work conscientiously with a high degree of accuracy.
• Meet goals and objectives as mutually agreed upon during last performance review (if applicable).
• Experience in CPT and ICD-10 coding;
  Familar with medical terminology and must be able to work with several different programs.

Expected to have a high school diploma and a minimum of two years post high school education and/or relevant experience. Preferred areas of experience include data…