Billing Specialist

Within Health is a Virtual company for Eating Disorders. As this company was started in 2021 we are looking for a quality team member to join our Revenue Cycle team.

**MUST HAVE EATING DISORDER OR INSTITUTIONAL CLAIMS FOR MENTAL HEALTH EXPERIENCE**

Job Summary:

The Billing Specialist's primary responsibility is to oversee the billing process for clients. Ensure timely and accurate submission and processing of client invoices and insurance claims. The Billing Specialist will also research and resolve all provider and client inquiries in a timely and customer-focused manner.

Major Areas of Responsibility:

• The primary function is to take ownership of the error free completion of the entire weekly bill cycle to include:
• Checking eligibility and benefit verification for services provided as needed
• Conduct client and guarantor welcome orientations on the insurance/private pay/balance billing process
• Maintain communication with clients on the billing process, status of their claims
• Manage the status of client accounts and balances and identify inconsistencies
• Create, send and collect on bi-weekly invoices for balance billing and SCA, private pay clients
• Follow up, collect, charge and post large client balances
• Professionally answer and respond to calls, and emails from patients, payers, and other team members re: claims, balances, eligibility, etc., promptly.
• Accurately prepare, review, and submit claims within timely filing to various insurance companies electronically, or in some case via paper using correct revenue, HCPCS, CPT and ICD10 codes
• Post insurance and patient payments from ERA's or EOB's within a timely matter.
• Follow-up on open, denied, underpaid, overpaid and non-paid claims and re-submit, send back, appeal as needed
• Write, compile medical records, etc. for appeals, retrospective reviews, authorizations as needed; and follow up accordingly.
• Collaborate with clients and insurance companies, team members to resolve billing inconsistencies and errors.
• Review patient accounts for trends that indicate where additional assistance might be needed.
• Constructively handle patient complaints and report to your supervisor immediately.
• Support billing team as needed when individual tasks are completed, or if help needed to complete a project.
• Monitor your daily, weekly performance and submit daily delegations to billing manager.
• Plan, organize, direct and control to meet all billing objectives.
• Maintain and track your personal calendar, calls, and deadlines.
• Motivate yourself to perform well.
• Communicate potential opportunities for optimization.
• Constantly strive toward continuing professional growth
• Accurate and timely processing of all adjustments (debits and credits), initiated by either external (client-related) or internal (Shared Services) requests
• Timely research and resolution of all billing inquiries to the assigned mailboxes utilizing the highest level of customer service

QUALIFICATIONS:

• High school diploma or equivalent require, some college preferred
• 3 years' experience in billing, preferably in the Staffing or Medical field
• 3-5 years of demonstrated analytical sense with excellent attention to detail
• Medical billing experience, specifically insurance company follow up and balance billing
• Understanding of billing on UB-04 forms and revenue, CPT, HCPCS, ICD10 codes
• Compliance of HIPAA, understanding of medical terminology
• Strong attention to detail and efficient data entry
• Strong organization, time management and prioritization abilities
• Excellent communication and Customer Service skills
• Strong computer skills, including knowledge of EMR's, PM systems, and Microsoft Office suite

Physical and Environmental Requirements:

• Employees are required to read, review, prepare and analyze written data and figures, using a computer or similar, and should possess visual acuity.
• This position answers and places telephone calls as well as video conferences and must be able to converse
• Must be able to converse with colleagues via telephone and computer programs.
• Must be able to operate a computer and navigate applications within a smart-phone, iPhone, MacBook computer and/or tablet.
• Able to sit for the majority of shifts.
• Must have reliable internet connection.
• This is a work-from-home position. Work should be performed in a private, quiet space with minimal background noise.
• Ability to prioritize workload and work independently.

Wage Range: $50-$60k/Year