Billing Specialist

Job Description

Job Description

Description:

Temporary - Full Time

Reports to: Billing Supervisor

Position Overview: 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.

Essential Position Responsibilities:

• 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.

Other Position Requirements:

• 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 entry, ten-key, and using Microsoft applications, primary Excel Spreadsheets. Must have knowledge of program development along with excellent communication skills (oral and written). Must demonstrate strong organizational skills with high detail orientation to meet specified deadlines. Must have knowledge of billing to outpatient and Medicaid providers. Knowledge of insurance companies is preferred but not required. 

Physical Requirements:

• Sitting for extended periods of time
• Typing/data entry/ten-key for extended periods of time
• Lifting/carrying up to 30 pounds
• Bending/stooping

All the above duties and responsibilities are considered essential job functions subject to reasonable accommodation. All job requirements listed indicate the minimum level of knowledge, skills, or ability deemed necessary to perform the job proficiently. This job description is not to be construed as a detailed statement of duties, responsibilities or requirements. Employees may be required to perform any other job-related instructions as requested by their supervisors, subject to reasonable accommodation.

EEO Race, Color, National Origin, Religion, Sex, Sexual Orientation, Gender Identity, Veteran, Disabled

EEO race, color, religion, sex, parental status, national origin, age, disability, genetic information, political affiliation, military service, or other non-merit based factors.