Billing Specialist (55410)

POSITION SUMMARY:

The Billing Specialist is responsible for the accurate and timely processing of claims. Billing Specialist will maintain AR for assigned payers and report any ongoing issues to Billing Manager. Billing Specialist will be expected to reach out to payers when issues arise.

DUTIES AND RESPONSIBILITIES:

• Managing payer and patient accounts receivables
• Working correction tickets for billings before or after payment has been received
• Submitting claims electronically through Availity Revenue Cycle Management and other clearinghouses
• Submitting secondary claims through Availity Revenue Cycle Management and preparing and mailing paper claims
• Making corrections to claims that have been scrubbed for errors in Availity before submitting
• Working claim denials through CareLogic
• Calling payers to appeal denials and working closely with payer representatives to correct erroneous denials
• Answering client questions regarding account balances
• Data entry
• Other duties as assigned by the Revenue Cycle Manager or Billing Supervisor

Qualifications

QUALIFICATIONS:

• High school diploma or equivalent is required
• Prior experience of 1 – 2 years in claims and billing preferred
• Billing or administrative experience in the Developmental Disabilities and/or Behavioral Health (Mental Health and Substance Use) field is preferred
• Microsoft Office/Excel is required
• Availity, KY Medicaid, software experience is helpful
• Comprehensive knowledge of ICD-10, CPT, and HCPCS coding

JOB REQUIREMENTS / EXPECTATIONS:

• Successful candidates must possess good oral and written communication skills as well as the ability to multitask and work efficiently in fast-paced environment. Must pass a legally required Criminal Record Check and a Sexual Offender Registry check.
• Must be able to work in a group setting with other billing specialists.
• The applicant hired into this role will be evaluated against company and department goals, objectives, and performance factors annually.

CORE VALUES:

All employees must be willing to live our company's core values.

• Integrity – Exhibiting the highest moral, ethical and legal standards. Doing the right thing – even when no one else is looking.
• Teamwork – Putting team success over personal success. Actively valuing the strengths and talents of others.
• Trust/Respect– Seeing and believing in the good intentions of others. Interacting with others in a way that makes them feel valued. Listening without judging. Offering understanding and acceptance.
• Care/Compassion – Demonstrating unconditional kindness, concern and empathy. Exhibiting genuine concern for others.
• Ownership/Accountability – Taking personal responsibility for one’s work, actions and feelings. Accepting responsibility for and learning from mistakes.