Billing Specialist

Reports to: Chief Financial Officer (CFO)

Pay Range: $26 to $31 per hour (DOE/DOQ)

Hours per Week: 40 hours

Workdays: Monday to Friday 8-5

Benefits:

• Medical, Dental & Vision Insurance
• Vacation, Sick Leave, Float Days & Paid Holidays
• 403(b) Retirement Plan
• Life Insurance
• Long Term Disability
• Wellness Program
• Employee Assistance Program
• LifeFlight Membership
• Education Allowance

JOB PURPOSE: The Billing Specialist is responsible for ensuring that all claims are processed timely and accurately, ensuring that all necessary procedures are completed prior to batch submission, denials and payments applied and/or addressed promptly, and that statements are finalized, in accordance with contracts.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Communicate professionally and directly with clients and staff regarding accounts.
• Keeps electronic health record, payer records and fee matrixes updated, ensuring compliance with payer contract terms.
• Verifies accuracy of billing data and corrects errors to ensure clean claims are produced.
• Perform corrections of client information that includes, but is not limited to, demographics and insurance information.
• Responsible for ensuring accurate and timely resolution of coding and billing issues.
• Obtains and/or enters such documents as authorizations, financial agreements, and other such ancillary documents, as necessary.
• Maintains detailed records and documents activities in client accounts when appropriate or as required.
• Resolves discrepancies in client accounting records.
• Interact with staff, clients, payers, and agencies to answer questions, obtain information, and resolve issues.
• Monitors aging reports and take such steps as necessary to guarantee timely payment of claims.
• Coordinates and collects necessary information from staff, clients, or payers for claim adjudication.
• Participates in take-back, overpayment, and refund process.
• Recognizes problem accounts and notifies appropriate staff or supervisors to assist in problem resolution.
• Assists in the creation of manuals and protocols.
• Participates in the training of new staff members.
• Maintains familiarity with and handles client information in accordance with Federal Regulations (42 CFR, Part 2), the Revised Code of Washington (RCW 71.05.390 and RCW 71.24), and other applicable laws pertaining to confidentiality of client and staff information.

REQUIRED EDUCATION, LICENSE(S), CERTIFICATION, AND EXPERIENCE:

Education: Minimum High School Diploma or GED

Experience:

• Two years of experience in claims billing using a centralized billing system or clearinghouse.
• Experience in healthcare billing.

PREFERRED ADDITIONAL CREDENTIALS / EXPERIENCE:

Education: Associate or Bachelor's Degree

Experience: Medical coding

Licensure: Certified Professional Coder

KNOWLEDGE, SKILLS, AND ABILITIES:

Essential:

• Experience with ICD-10, CPT, and medical terminology preferred.
• Must be proficient in Excel, Word, and ten-key by touch.
• Experience with Qualifacts CareLogic or similar EHR system.
• Excellent verbal and written communication skills.
• Excellent customer service skills.
• Must be able to resolve client billing problems in a timely manner.
• Must have the ability to add, subtract, multiply, and divide in all units of measure using whole numbers, common fractions, and decimals.

*Peninsula Behavioral Health does not discriminate because of a person's presence of any sensory, mental, or physical disability, race, creed, color, national origin, sex, sexual orientation, gender identity including transgender status, marital status, pregnancy, childbirth, and pregnancy-related conditions, age (40), honorably discharged veteran or military status, or use of a trained dog guide or service animal by a person with a disability, state employee or health care whistleblower status.