Billing and Claims Specialist

Job Purpose:

As a Billing and Claims Specialist, you will play a crucial role in ensuring accurate billing processes for our healthcare facility. Your attention to detail, knowledge of medical coding, and understanding of insurance verification will contribute to the financial success of our organization.

If you are a detail-oriented individual with strong analytical skills, we encourage you to apply. Additionally, the Billing and Claims Specialist will perform administrative and customer service functions with the Medical Records Administration and Intake Specialist.

Duties:

• Communicates with patients to verify upcoming appointments via Electronic Medical Record (EMR) schedule.
• Works closely with 3rd party billing agency to coordinate errors in billing from mailed Explanation of Benefits Reports (EOB’s).
• Assign appropriate ICD-9, HCPCS, and DRG codes to medical procedures and services.
• Organize and track all insurance claims filed by the health care provider.
• Follow-up until payment is received and manage collections activities when necessary.

· Answer patient questions on billing, arrange payment plans for those who need them, and handling collections if a patient fails to meet their financial obligations.

· Maintains the compliance of the department with clinical practices and local, state, and federal regulations.

· Submit, organize, and track all insurance claims filed by the health care provider.

· Maintains all patient demographic information in paper and electronic medical record system and service reports.

· Receive, process, and post customer payments.

· Prepare patient delinquent balance statements when necessary.

· Analyze, interpret, and verify service report claims accurately sent to insurance companies.

· Verify patient insurance and troubleshoot insurance carrier issues relating to Billing and reimbursements.

· Assist Accounts Payable department with all billing.

· Uses clinically appropriate professional terminology to complete forms and records and maintain knowledge of ICD-10 Billing and coding medical procedure codes.

· Adheres to confidentiality requirements.

May perform telephone screenings for new patients with an Intake Specialist.

· Attends monthly Billing and service claims meeting with 3rd Party Billing Coordinator.

· Performs related duties as assigned and attends mandatory in-services.

Skills/Qualifications:

· Should be comfortable using a computer, its software, and all other office equipment.

· Must be proficient in Microsoft Word, Excel, PowerPoint, and Publisher computer programs.

· Must possess excellent communication, organizational, and interpersonal skills.

Required Degree or Certification:

· High school diploma or GED and 12 credit hours of college education in substance abuse counseling and/or other human services area (preferred).

· Must be a Certified Medical and Billing Professional within 90 days of hire or already certified as a Medical and Billing Professional.

· Associates, BA, or BS Degree in a related field (preferred).

Minimum experience required:

· Completed 150-200 hrs. of Intern or Externship with a Certified Billing, Coding or Medical Administrative Assistant Program, School, or Medical Training Certificate.

· Must be Certified Medical and Billing Professional within 90 days of hire.

Job Type: Part-time

Pay: $18.50 - $20.00 per hour

Expected hours: 32 per week

Benefits:

• 401(k)
• 401(k) 4% Match
• 401(k) matching
• Paid time off

Schedule:

• Day shift
• Monday to Friday
• No weekends

Work setting:

• In-person
• Office

Experience:

• Medical billing: 1 year (Required)

License/Certification:

• Medical Billing Certification (Required)

Shift availability:

• Day Shift (Required)

Work Location: In person