About the Position: The billing specialist will work under the direction of the President/Clinical Director & RCM Manager. This job requires organization and motivation to help support the company's growth and help us provide exceptional services to our clients. You will be asked to complete billing and authorizations related tasks.
Requirements:
- Preferred experience in ABA billing
- Experience working directly with government and third party insurance companies
- This role also requires EXCEPTIONAL attention to detail, critical thinking, and excellent communication with clients and insurance companies
- Individual must be willing to work during typical office hours
- Experience using Central Reach billing platform (preferred)
Responsibilities:
- Ensure strict HIPAA-compliant confidentiality with all client-related data
- Review & interpret payor contracts for customers
- Evaluate, troubleshoot, and follow-up on customer concerns
- Review customer account reports and follow up to ensure any flags/concerns are notated proactively
- Research specific payor billing rules as needed and update/maintain internal payor database
- Review client billing documentation to ensure claims are submitted based on payor requirements
- Create claims and patient statements
- Submit claims electronically for primary and secondary payers
- Bill out for patient responsibility weekly and follow up according to protocol
- Respond to emails within 24 hours
- Monitor the billing & authorizations email inbox and keep it clean & organized
- Collecting for services using billing software (including posting, authorization and billing bots)
- Follow up on rejections, denials, and any outstanding claims
- Submit corrected claims as needed
- Post payments and maintain A/R
- File appeals to insurance
- Stay informed about Payor and Industry Billing rules
- Assist to train, direct, develop and evaluate new staff
- Develop and perform quality assurance audits to ensure timelines for billing are being met
- Measure and monitor key metrics related to work performance
- Foster a positive work environment for colleagues
- Achieve 95-100% monthly collection rate within 60 days month end and be prepared to report on outstanding revenue, billing trends, etc.
- Cross-train and/or assist with credentialing, authorizations, other billing department related duties as assigned