Billing Specialist

Billing Specialist

Salary Range $21.00 - $25.00 Hourly Position Type Full Time Job Shift Day Education Level High School

Description

POSITION OVERVIEW: The Billing Specialist is primarily responsible for completing billing activities for all third-party payers and private pay clients. Additionally, this position will provide key support for revenue reporting, audits and other billing management functions. The Billing Specialist reports to the Director Revenue Cycle.

Principal Responsibilities:

• Timely importing of electronic remittance advices (ERAs). Strict monitoring of insurance appeals and Accounts Receivable balances.
• Coordinates coding and payment issues with other areas and departments as required.
• Receive, investigate and respond to client billing inquiries and requests.
• Follow up with clinicians on any documentation that is insufficient or unclear.
• Develop and maintain relationships with all third party payers to get authorizations, investigate claim denials and resolve collections issues.
• Responsible for reviewing cash sheets and applying copays to client accounts
• Work in partnership with the Compliance team.
• Monitor and work aging accounts as needed.
• Cross train within department to provide coverage when necessary.
• Inputting payment history, upcoming payment information, generating client statements, and ensuring accuracy of individual accounts.
• Enter charges and payments into electronic health records, including posting payments and researching and investigating unapplied credits.

COMPETENCIES: Must demonstrate the following competencies:

Diversity and Inclusion: Foster an environment in which all members of the Clifford Beers community, from staff to partners and clients, are treated equitably and are able to contribute fully and meaningfully to the mission of Clifford Beers. Employees must make every effort to:

• Treat others with respect
• Practice cultural humility
• Elicit and welcome different points of view

Integrity: Act ethically with honesty and consistency regardless of the situation. Employees must make every effort to:

• Be accountable for his or her own actions
• Make decisions based on what is better for the families and employees
• Build and maintain trust among co-workers and our families
• Uphold honesty in all actions

Excellence: Commitment to deliver outstanding practices in both managing the organization, service delivery, and collaborating with partners. Employees must make every effort to:

• Utilize data and research to provide the highest quality of care
• Regularly participate in professional development to stay abreast of most recent and progressive practices
• Promote continuous quality assessment and improvement

Communication: The ability to express oneself clearly and professionally both in writing, conversations, and in nonverbal communication with others. Employees must make every effort to:

• Oral Communication - Speak clearly and in an organized manner that can be easily understood
• Express ideas concisely and respectfully
• Summarize or paraphrase his/her understanding of what others have said to verify understanding and prevent miscommunication
• Hold herself or himself accountable for pitch, speed, tone and volume of voice while speaking
• Show understanding of professional and cultural implications of body posture, stance, gestures, proximity to listener, facial expressions and appearance
• Written Communication - Write clear and concise sentences devoid of grammatical and spelling errors
• Tailor writing style to the audience of the message
• Write in a respectful and tactful manner

REQUIREMENTS: - Valid driver's license and reliable transportation

TRAVEL: - This role may require travel throughout the State of Connecticut.

PHYSICAL ABILITIES: - 20% of the time is spent making repetitive motions - 30% of the time spent sitting - 20% walking, bending, standing, stooping, crouching or kneeling - 30% of the time is spent using hands to type, write, or use controls - Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

ENVIRONMENTAL CONDITIONS - Indoors, Environmentally controlled - Close Physical Proximity to coworkers

Reporting Relationships: The Community-Based Clinician will report to the Director of Community-Based Services.

Qualifications

EDUCATION and EXPERIENCE:

• 3+ years of Medical Billing experience
• Experience in billing in behavioral health care.
• Experience reconciling and resolving billing transactions with the accounting general ledger system is a plus.
• Experience working within an Electronic Health record required, experience with Carelogic EHR a plus.