Insurance Billing Specialist

Description

Position Summary:

The Insurance Billing Specialist offers accurate data submission, to relay accurate and timely information to management, staff, and other identified end users. This position will work both independently and part of a team to monitor and complete expected data analysis and quality assurance assignments. This position is expected to complete work in a timely, professional manner consistent with data submission standards

Responsibilities:

Review explanation of benefits from the insurance carriers to post appropriate payments and denial codes.

• Identify remittances with a secondary payer and takes appropriate action to send to secondary carriers.
• Analyze balance reports to ensure accurate postings.
• Input zero payment vouchers and insurance denials from all payer sources in a timely manner.
• Assist staff with payment and adjustment questions and research as needed
• Post manual payments not posted electronically; post allowances, adjustments, and write-offs/write-ups.
• Process refunds and recoups within the EHR system

Complete Applied Behavioral Analysis (ABA) billing.

• Obtain authorization for all payers that require a prior authorization and communicate with the ABA staff for authorization extensions.
• Email ABA staff regarding failed activities
• Prepare, review, and submit clean claims to insurance companies/clearing house electronically.
• Identify and resolve client billing complaints.
• Maintain working knowledge of regulations for Federal, State, and third-party payers, including, but not limited to: Medicaid, Tribal billing, and commercial insurance.
• Assist insurance companies with billing and reimbursement issues; follow up with payment, denials, and appeals.

Maintain confidentiality of all business practices and adhere to all HIPAA guidelines/regulations.

• Participate in Managed Care meetings for data updates as needed.
• Respond to emails in a timely and professional manner.
• Maintain current knowledge of CPT codes and descriptions.
• Stay informed with current insurance billing requirements and changes.
• Assist with special projects, and other duties as assigned.

Perform other duties as assigned.

Job Requirements:

The following requirements are those that are normally required for performance of this position. Any disabled applicant or incumbent who does not meet one or more of the requirements, but who can perform the essential function of the job (with or without reasonable accommodations) shall be deemed to meet these requirements.

Physical Requirements:

This position normally requires the physical demands of standing, walking, bending, lifting or performing other work requiring low physical exertion, talking and hearing and adequate vision on a regular basis to perform job requirements. These physical demands are required up to 90% of the time.

Non-Physical Requirements:

Education

• High School Diploma, Required
• College Degree or Certificate of Completion (Computer Science, Behavioral Analytics, Finance, Accounting) - Preferred

Experience

• 2 years’ experience with EHR Systems (CareLogic QualiFacts experience preferred)
• Knowledge of State Data requirements related to community Mental Health
• 3 years billing experience required (Physician Billing preferred)

Special Skills

• Pleasant, welcoming, and friendly demeanor with staff and clients
• Able to work independently or as part of a team.
• Knowledge of office practices and procedures
• Detail oriented and able to multi-task
• Computer word processing using Microsoft Office and Google Docs
• Experienced with the use of standard office equipment, including computers, copiers, fax, phone, calculator, TTY, and/or other equipment found in work unit.
• Maintain positive, team-oriented service attitude toward clients and staff.
• The ability to work independently with strong problem-solving skills.

Licenses, Registration, Or Certification

• Valid Washington State Driver’s License and required minimum liability insurance for WA State

Employment is conditional upon:

• Being cleared by criminal background check and fingerprinting when required

Qualifications

Salary : $22 - $26