Billing Specialist I (Remote Eligible in Specific States) (R&D)
General Purpose
The Billing Specialist is responsible for all aspects of the billing and accounts receivable process including filing, processing, and posting of charges/claims generated from behavioral and physical health services.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Duties/Responsibilities
Verify payor information and eligibility, and obtaining prior authorizations for clients/patients.
Send monthly billing for all third party payors such as CORE, PASSR, and EAP services.
Prepare and mail patient/client statements monthly.
Communicates and follows up with insurance companies regarding claim issues.
Serves as the point of contact for billing and insurance questions.
Files and maintains billing information such as EOB's, denials, and payment remittances.
Reconciles and posts transactions into the EHR system.
Generates and sends billing and encounter files.
Communicates with clinical and administrative staff regarding billing errors that require correction.
Prepares and deposits daily bank deposits.
Configures and maintains practice management settings in EHR.
Processes billing tickets.
Supervisory Duties (if any)
None
Job Qualifications
Knowledge, Skills, and Ability:
Computer software skills including Word, Excel, and Outlook.
Ability to maintain confidentiality and exercise discretion.
Ability to work collaboratively with others in a multi-cultural environment.
Ability to utilize, as well as knowledge of, electronic health record, billing, and/or practice management systems.
Knowledge of state and federal regulations regarding billing commercial insurance, Medicare, and Medicaid.
Knowledge of ICD10, CPT, and HCPCS codes, as well as medical billing and coding.
Education or Formal Training:
High School Diploma or GED required.
Experience:
Minimum of three years medical billing experience.
Minimum of 1 year customer service experience.
Additional Information:
• In-office or Hybrid eligible - Office location is in Canon City, CO.
• Remote work is only eligible in the following states: Colorado, Alaska, South Dakota, North Carolina, Massachusetts, Pennsylvania, Indiana, or Minnesota.
• The work schedule is Monday through Friday, 8 am to 5 pm (Mountain time, but it may be flexible for states in other time zones).
Working Conditions and Other Conditions of Employment
Working Environment:
This job operates in a fast-paced, professional office environment and routinely requires the use of standard office equipment such as computers, phones, photocopiers. The position may require travel to conferences, meetings and branch locations on a regular or intermittent basis. Work may involve moderate exposure to unusual elements, such as extreme temperatures, dirt, dust, fumes, smoke, unpleasant odors, and/or loud noises. In the health center environment, there is potential for contact with blood-borne pathogens and communicable diseases, as well as potential for contact with dissatisfied or abusive individuals. There could be interaction with persons who are mentally ill, disabled, elderly and emotionally upset.
Physical Activities:
These are representative of those which must be met to successfully perform the essential functions of this job.
This is a largely sedentary role but can involve standing or sitting for extended periods of time, bending at the waist, and using hands and fingers to handle and file papers or operate assigned equipment. While performing the duties of this job, the employee is regularly required to talk or hear. Specific vision abilities required by this job include close vision, distance vision, color vision, and ability to adjust focus. Employee may also have to lift 10 to 25 lbs. unassisted.
Conditions of Employment:
Annual TB, federally required drug screening, and Influenza vaccination or compliance with policy and procedure.
Required possession of a valid state driver's license.
Successful candidate must submit to and pass, post-offer drug screen.
