Revenue Cycle Specialist (Biller)

Job Description

Job Description

• Generate billing invoices for multiple programs and multiple insurance companies either in paper format or electronically.
• Monitor all consumer accounts and prepare claim resubmission when needed. Perform billing functions in compliance with state and other billing regulations.
• Contact insurance companies regarding rejections, patient coverage, and authorizations pertaining to mental health and drug and alcohol services. Contact managed care and HMO organizations to establish proper guidelines regarding therapeutic and billing procedures.
• Monitor reimbursement rates from insurance companies for accuracy and compare to the fee schedule and the system.
• Read updates from insurance companies and track changes received. Notify appropriate personnel of yearly changes in fee schedules or other insurance practice changes. Maintain files housing this information.
• Prepare itemized statement for client and/or insurance companies requesting account information.
• Process necessary authorization requests. Scan and attach all received authorizations to the Consumer record in the system.
• Enter all received authorizations into system. Obtain necessary authorizations for all departments as directed. Communicate with managed care companies for authorization when insurance changes occur. Communicate when write- offs/authorizations are in question.
• Adhere to seven recognized Sanctuary commitments which includes social responsibility, social learning, non-violence, open communication, democracy, emotional intelligence, growth and change.