Billing Specialist

Advertised Job Type: Permanent - Full-time regular employment

Work Type: On Site

Job Description

Job Overview

Process and submit client insurance billing

Work Schedule

Monday – Friday, 8:00 AM – 4:00 PM

Employee Classification

Hourly, Full-time

Qualifications

High school diploma or higher. Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Publisher, Access), Google Business Suite. Experience with database software such as Central Reach is a plus.

Essential Responsibilities

The primary duties of the position include:

Prepare, review and bill claims via Central Reach/OfficeAlly, NCTracks Portal

Check claim status on appropriate payors systems and contact insurance as needed

Resolve denials for unpaid and rejected claims, follow up on outstanding claims and adjust accordingly

Send medical records and other documentation to payors, as requested

Review timesheets and billing entries in Central Reach to ensure accurate information

Post payments (electronic and manual) in billing software

Collaborate as needed to ensure all requirements are obtained for timely enrollment of clients and submission for authorizations

Authorizations

Collaborate to ensure timely and accurate verification of client’s ABA benefits eligibility through primary and secondary payers

Gather and submit required documentation to gain authorization for ABA services, following up within the agency as necessary

Send requested information to insurance carriers, as needed

Foster relationships with payor partners, follow-up on submitted authorization requests

Monitor and report on the status of authorization requests and issues

Work with the leadership to ensure timely completion of documentation

Practice Management Software

Manage client accounts, upload documentation required for billing, add payers, connect clients to providers and service codes, fee schedules, etc.

Perform weekly billing audit, screen for non-billable time, code overlaps, schedule inconsistencies, code requirements and MUEs

Document insurance billing related correspondence in the appropriate location, for example: calls and relevant/important information

Scan documents such as authorization letters, EOB's, correspondence from payers and upload into practice management software

Assist leadership with updating billing software with rate changes

Contact Central Reach to resolve any issues

Other

Track and report back any missing materials for insurance onboarding to appropriate departments

Attend webinars and report back to relevant parties as directed

Follow HIPAA regulations when handling all patient information