What are the responsibilities and job description for the Billing Specialist position at Shawnee Counseling Center, LLC?
Job Title: Billing Specialist
Reports to: COO
Job Description: The role of the Billing Specialist is to ensure behavioral health claims are billed following all federal and state guidelines and requirements of payers. A Billing Specialist is responsible for processing daily billing claims in a timely and accurate manner. This job requires strong attention to detail.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Review clinical documentation billing reports for accurate and complete diagnostic and procedure information.
- Review all departmental billing guides, payer rules, and any changes to billing guidelines
- Maintain current working knowledge of Medicaid billing regulations and requirements
- Prepare clean claims to be sent to insurance companies electronically
- Actively works with the Utilization Review Department if an issue with a patient's authorization is presented
- May be required to request diagnosis or other data from providers when not recorded in the clinical documentation if the information is incomplete.
- Determines the correct sequence of primary and secondary diagnoses according to provider documentation.
- Applies knowledge of ICD-10, CPT, HCPCS, and modifiers to all provider coding and billing assignments.
- Verify completeness and accuracy of all claims prior to submission.
- Ensure claims are submitted with a goal of zero errors.
- Communicate with other departments to assist with answering questions when needed.
- Consult supervisor, team members, and appropriate resources to solve billing questions and issues.
- Maintain work operations and quality by following standards, policies, and procedures; escalate compliance issues to supervisor.
- Attend meetings with Supervisors to discuss departmental information
- Interacts with providers and peers face-to-face, by telephone, and in writing in a professional and productive manner.
- Maintains the strictest confidentiality; and adheres to all HIPAA guidelines/regulations.
- Work efficiently and effectively in the Billing software system to ensure clean claims are sent to the payers appropriately.
- Protect the privacy of all persons served/client information in accordance with Shawnee Counseling Center's privacy policies, procedures, and practices, as required by federal and state law, and in accordance with the general principle of professionalism as a healthcare provider
- Perform additional duties as requested
Disclaimer
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. In addition, all personnel may be required to perform duties outside off their normal responsibilities from time to time as needed.
This job description is not an employment agreement or contract. Management has the, exclusive right to alter the scope of work within the framework of this job description at any time without prior notice.
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Job Type: Full-time
Pay: $20.00 - $25.00 per hour
Expected hours: 40 per week
Benefits:
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid sick time
- Paid time off
- Retirement plan
Work Location: In person
Salary : $20 - $25