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