Billing Specialist Job Description
Job Overview: Process and submit client insurance billing
Reports To: Revenue Cycle Manager
Work Schedule: Monday – Friday, 8:00 AM – 4:00 PM
Employee Classification: Hourly, Full-time
Qualifications: High school diploma or higher. Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Publisher, Access), Google Business Suite. Experience with database software such as Central Reach is a plus.
Essential Responsibilities: The primary duties of the position include:
Billing
- Prepare, review and bill claims via Central Reach/OfficeAlly, NCTracks Portal
- Check claim status on appropriate payors systems and contact insurance as needed
- Resolve denials for unpaid and rejected claims, follow up on outstanding claims and adjust accordingly
- Send medical records and other documentation to payors, as requested
- Review timesheets and billing entries in Central Reach to ensure accurate information
- Post payments (electronic and manual) in billing software
- Collaborate as needed to ensure all requirements are obtained for timely enrollment of clients and submission for authorizations
Authorizations:
- Collaborate to ensure timely and accurate verification of client’s ABA benefits eligibility through primary and secondary payers
- Gather and submit required documentation to gain authorization for ABA services, following up within the agency as necessary
- Send requested information to insurance carriers, as needed
- Foster relationships with payor partners, follow-up on submitted authorization requests
- Monitor and report on the status of authorization requests and issues
- Work with the leadership to ensure timely completion of documentation
Practice Management Software:
- Manage client accounts, upload documentation required for billing, add payers, connect clients to providers and service codes, fee schedules, etc.
- Perform weekly billing audit, screen for non-billable time, code overlaps, schedule inconsistencies, code requirements and MUEs
- Document insurance billing related correspondence in the appropriate location, for example: calls and relevant/important information
- Scan documents such as authorization letters, EOB's, correspondence from payers and upload into practice management software
- Assist leadership with updating billing software with rate changes
- Contact Central Reach to resolve any issues
Other:
- Track and report back any missing materials for insurance onboarding to appropriate departments
- Attend webinars and report back to relevant parties as directed
- Follow HIPAA regulations when handling all patient information
Pay Range: $20 - $22 per hour
St Gerard Center for Autism does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor. We believe a diverse workplace is the ideal and encourage everyone interested in applying.