Position exists to collect and process information to complete all components of complex third party billing and supports additional activities in the office and the accounting department as assigned.
Essential Functions and Responsibilities:
1. Process targeted case management services which includes, gathering service data from staff, compile and analyze data to determine appropriate billing procedure, enter data into claims submission software, develop and maintain spreadsheets to monitor billing activity and compile requested reports.
2. Follow-up with staff as needed to ensure compliance of required documentation related to program activity and billing.
3. Communicate regularly with staff to ensure service information is received, entered, and meets established deadlines.
4. Process insurance claims, verify insurance benefits for clients, staff credentialing, and monitor prior authorizations.
5. Resolves denied insurance claims along with researching & resolving the agency’s aging accounts receivable.
6. Assist with accounting department duties including but not limited to processing client billing utilizing accounting software, daily deposits, manage complex spreadsheets, and other related duties as assigned.
7. Completes all processes to adequately bill waiver services. Reviews and manages the corresponding client service agreements to ensure the agreements provided encompass sufficient authorizations to allow for billing of services provided. Resolves discrepancies, shortages or other concerns within existing agreements promptly so that revised/new authorizations can be obtained to bill for services provided.
8. Assists in processing and maintaining cash receipts ensuring that accurate records are kept and client/customer billing statements are correctly processed.
1. Filing as needed, including scanning & uploading documentation to electronic database.
2. Processes & coordinates requests for medical records.
3. Provide occasional back-up for reception staff to ensure front office coverage at all times to receive phone calls and visitors.
4. Assists in completing intake calls for the agency.
5. Other duties as assigned.
No direct supervisory responsibility
Training and Experience:
Requires training and work experience that demonstrates advance skills in processing third party insurance/claims, spreadsheet development and management, computer literacy in MS Office and problem solving. Vocational or other advanced training in accounting/bookkeeping highly desirable.
Knowledge, Skills and Abilities:
Must possess intermediate skills and literacy in MS office software to perform assigned tasks. Requires accuracy in data entry and must possess numeric aptitude. Knowledge of computerized insurance/medical assistance billing and electronic database software is required. Must have highly developed organizational skills with the ability to handle and manage large volumes of detailed confidential information, possess good follow-through skills, be self-motivated, and have excellent problem solving ability.
May occasionally need to flex standard work schedule to meet critical deadline.
Must be able to regularly talk, hear, sit, and perform keystrokes to enter data with speed to ensure work is completed in a timely fashion. Requires physical ability to routinely handle normal office materials and tools including frequent filing, lifting, and reaching; ability to move throughout office areas to complete work assignments.
Exposure to normal office heating and cooling systems and chemicals used for normal office equipment.