Billing Specialist (Senior)

Position Summary:


Handles the processing of sorting and receiving incoming payments with attention to accuracy along with managing the status of accounts/balances and identifying inconsistencies.

Position Description:

• Appropriately assemble reimbursement claims, file and transfer to third party vendors.
• Assists with consistent and timely follow-up on unpaid claims, denials, exceptions or exclusions in various portals
• Issue and post bills, receipts and invoices; verify completeness & accuracy of all claims prior to submission; accurately post by line item and balance movement to subsequent payers
• Assist with medical record requests, completion of additional information requests, etc. as requested by payers, patients and providers
• Update claims management database with new accounts or missed payments
• Full understanding of primary, secondary, tertiary claims and ability to determine if CARC and RARC are accurate
• Complete forms, files and records in a confidential, accurate, timely manner, assuring completeness of all information and presence of all required documentation including refunds, recoupment request, adjustments, etc.
• Ensure all clients remain informed on their outstanding debts and deadlines; provide solutions to any relative problems for clients
• Write thorough reports on billing activity with clear and reliable data; ability to acquire and interpret payer eligibility and explanation of benefits
• Perform special projects of a moderate to complex nature; meet deadlines; filing appeals when appropriate
• Regularly meet with Billing Manager to discuss and resolve reimbursement issues or billing issues; regularly attend staff meetings and educational sessions
• Performs special projects of a moderate to highly skilled nature; ability to perform level 2 errors; ability to work claims and enrollments in Mental Health Board systems
• Other duties as assigned

Required Knowledge, Skills and Abilities:

• Proven experience as a billing specialist
• Mental Health Recovery Services Board billing
• Proficient in Excel (including V-Look up, pivot tables and moderate to advanced excel functions), navigating EHR/EMR portals & Claims management platforms
• Electronic health record software
• Excellent attention to detail; comfortable dealing with numbers and the processing of financial information
• Results-driven and ability to manage stress in a fast-paced environment
• Excellent customer service skills
• Knowledge of medical billing, CPT & ICD-10 coding and collection process, and contract specifications

Job Requirements:

• High School diploma or High School Equivalency (college degree preferred)
• 5 years of proven experience in billing

Essential Functions/Physical Demands:

• Positional: Driving in accordance with job duties assigned. Infrequent standing and walking. Constant sitting.
• Gross Mobility: Rare climbing, or crawling. Infrequent balancing, stooping, kneeling, or crouching. Frequent to constant reaching adn handling.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or on the basis of disability.