The Substance Use Disorder Billing Specialist III is an essential part of the team
and will assist with billing for Medicaid and private insurances for addiction programs. Produces and
maintains accurate and timely claims for addiction services rendered and will process and follow-up
on Medicaid billing, review remittance advice forms to verify proper reimbursement, and adjust as
necessary. Will ensure accounts receivable for services provided is accurate and records payment
received. Maintain client confidentiality and information security following the HIPPA Regulations.
This position will work closely with the Billing Coder Supervisor to ensure billing accuracy.
ESSENTIAL JOB DUTIES AND RESPONSIBILITIES include the following, and other related
duties as assigned.
1. Ensures that the activities of the billing operation are conducted in a manner that is consistent
with overall department protocol, and are in compliance with federal, State, and payer
regulations guidelines and requirements.
2. Checks to ensure that billing related documentation for clients include all information required
for Medicaid reimbursement.
3. Verifies correct Medicaid coding to ensure prompt payment.
4. Verify essential note information (i.e. units of services, time start and end time)
5. Daily, weekly and monthly review and data entry of billable service.
6. Generates treatment services in Methasoft and submit to LCS billing Supervisor or designee.
7. Inputs correct billing information and transmits electronically to the Medicaid carrier. Keep up
to date with carrier rule changes and distribute the information within the practice.
8. Consults with claim clerks in the Medicaid office about any disputed claims and follows up on
all bills not processed within usual claim period.
9. Monitor and review denied claims and resubmit treatment services
10. Interact with clients, counselors, Tribal Assistor and Target Data Entry regarding information
needed for claims.
11. Reviews remittance advice forms to determine any adjustments made to bills as submitted and
consults with Medicaid office.
12. Authorize or adjusts claim bills to correct errors.
13. Maintain and store all billing supportive documentation as required by state guidelines.
14. Assists in maintaining confidential files both physical and electronic forms.
15. Prepare weekly and monthly reports of Medicaid billing for the controller's office.
16. Assists management in reconciling data.
17. Maintain client confidentiality and information security following the 42cfr part 2 & HIPPA
Law.
18. Other duties as required to meet program goals, subject to change as needed.
MINIMUM QUALIFICATIONS:
- Associate degree in Accounting, Medical Billing, Medical Coding, or related field; and
o Three (3) years of experience in medical billing; and
o Three (3) years of experience with Methasoft or similar medical software; OR
- Bachelor's degree in Accounting, Healthcare Administration, Healthcare Information
Management, or related field; and
o One (1) year of experience in medical billing; and
o One (1) year of experience with EPIC or similar medical software; OR
- Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or similar credential.
- Must possess a valid Washington State Driver's license and meet eligibility requirements for
tribal insurance.
- Lummi/Native American/Veteran preference policy applies.
KNOWLEDGE, ABILITIES AND SKILLS:
- Ability to communicate clearly and professionally
- Ability to accurately and effectively compose correspondence and reports.
- Knowledge of Addiction Medicine billing/collection practices required. Familiar with Methasoft
billing or similar
- Ability to safely and successfully perform the essential job functions consistent with ADA,
FMLA, and other federal and state and local standards, with or without reasonable
accommodations, including meeting qualitative and quantitative productive standards.
- Works well in environment with firm deadlines; results orientated.
- Able to work both independently and as part of a team
- Ability to maintain regular, punctual attendance consistent with Lummi HR policies.
- Ability to maintain a positive, solution-focused demeanor when responding to conflicts or
problems.
REQUIREMENTS:
- Must pass pre-employment and random drug and alcohol test to be eligible for and maintain
employment, as required by the LIBC Drug & Alcohol Free Workplace Policy.
- Position requires Criminal Background Check.
- Must have HIV/AIDS and airborne pathogens eight (8) hour training or willing to take the next
available training.
- Must provide evidence of CPR training or willing to register in the next available class.
Employment Type: Full-Time
Salary: $ 25.00 28.00 Per Hour
