This position works under the supervision of the Controller. Responsibilities include following insurance claims through the full billing cycle from submission to appeals as well as client statements and follow-up for a set group of payers. This position requires clear understanding of the rules of confidentiality, the ability to exercise sound judgment, previous billing experience and knowledge of the behavioral health vocabulary.
- Submit billing to various insurance companies and post payments within timely limits.
- Resolve clearinghouse claim edits within timely limits.
- Follow-up on denials and submit appeals to insurance companies for payment within timely limits.
- Acquire benefit coverage in regards to behavioral health and obtain authorizations.
- Communicates patient benefits to staff and consumers appropriately.
- Work various reports; collections, aging, reconciliations, service pended, and closed client reports.
- Correct set up of patient billing, follow-up and resolve of billing issues.
- Work with billing department staff in a team-oriented approach.
- Interact with internal and external agencies in a professional and customer friendly manner.
- Able to prioritize and work independently.
- Back up in the department for other positions.
- Requires knowledge of medical billing and collection practices/procedures for commercial insurance companies, Medicare and Medicaid.
- Experience with the overall billing process: claims- electronic and paper, authorizations, payment posting, CPT coding, benefit verifications, EOB’s and ERA’s.
- Excellent computer and customer service skills are required. Excel experience is required.
- Experience with aging reports and general ledger reconciliations.
- Basic Accounting skills.
- Able to contribute and be part of a team.
Other duties as assigned by supervisor