Billing Specialist

Billing Specialist I- All School Sites Department

Under the direct supervision of the Revenue Cycle/ Credentialing Manager, the billing specialist is responsible for timely and accurate billing of all medical, dental, and behavioral health claims, insurance information, patient charges and payments. The Billing Specialist will work on a team in various aspects of claims submission for all school-based sites and/or other CRCHC clinic sites as needed. This individual should be resourceful, exceptionally detail-oriented and organized to be successful in this role. Having the ability to focus as well as shift gears as needed when handling competing priorities is required.

Minimum Qualifications Ability to read, write and comprehend the English language. Communicates effectively. Must be able to sit and stand for long periods of time. Ability to effectively maintain confidentiality of records and communicate with all levels of personnel.

Experience: One year of clerical experience in an office setting Additional skills required: Requires excellent organizational, problem solving and critical thinking skills. Strong basic computer skills required. Able to maintain confidentiality and work collaboratively in a team environment.

Travel required: Ability to travel to all CRCHC locations and assist at all CRCHC special population clinics. Additional skills preferred: Bilingual in Spanish and English, Intermediate experience using Athena and/or Dentrix EMR systems. Minimum of 1 year of coding, billing, and/or charge entry experience in the healthcare field is required Education: High school diploma or GED. Associates Degree preferred. Certification(s)/Licensure: N/A Physical Requirements: The physical demands described here represent those that must be met by an employee to successfully perform the essential functions of this job. Repetitive movement of hands and fingers typing and/or writing. Occasional standing, walking, stooping, kneeling, or crouching. Reach with hands and arms. Talk and hear.

Key Responsibilities

• Enter charges & transmit clean claims per coding, carrier, and contract guidelines.
• Experience in dental, medical billing and AR oversight/investigation is required for this role.
• Assist patients with billing questions.
• Answer incoming phone calls.
• Claims filing related to medical and behavioral health.
• Accurately and efficiently posting/applying payments.
• Complete all Medical and Behavioral Health requests for all CRCHC School Based locations in terms of prior authorizations and referrals.
• Review patient chart for records requiring updating and perform necessary updates.
• Create patient claim, collect payment, and document payment in electronic health record.
• Troubleshooting and follow through for open issues related to unidentified payments, insurance retractions and payment discrepancies.
• Assisting in researching and resolving claim denials, patient refunds, and collections follow-up.
• Compose messages to provider/staff regarding patient communication.
• Maintain a clean, neat, and well-organized work area.
• Verification of patient insurance plans.
• Entering insurance plan information in practice management software.
• Participate in quality improvement activities by initiating or contributing to monitoring, measuring, analyzing, improving and/or controlling program goals, objectives and/or services.
• Will post all medical and dental payments into both practice management systems (Athena)
• Billing Specialist will perform duties of collection on past due accounts for both medical and behavioral health.
• Perform other duties as assigned.