The Link & Option Center, Inc.

Compensation

Full Description

PROGRAM: Administration POSITION TITLE: Billing and Claims Specialist REPORTS TO: Revenue Cycle Manager JOB TYPE: Full Time SUMMARY: Responsible for prompt and accurate claim submission and follow up on billing denials received from all Insurance Payors. Denial follow up consists of directly contacting Insurance Payors to understand what is needed to process and reimburse all outstanding claims. Ability to generate revenue through consistent clean claim submission and reduce accounts receivable days, all conducted in an efficient, timely manner. ESSENTIAL DUTIES & RESPONSIBILITIES: · Reviewing Payer Balances in Electronic Health Record and Document follow-up progress · Troubeshooting and Researching claims and re-billing if necessary, including appealing denials or incorrectly paid claims. · Aggressively pursuing insurance companies > 30 days past due · Monitoring and Reporting on Payer’s status on a regular basis · Apply 835 payment and denial files into Electronic Health Record and research as needed on a daily basis; Apply and Approve Unapplied Payments · Work with payers and program staff to ensure proper authorizations for services are provided · Generate Management Reports on what is outstanding for each payor and what the denial reasons are. Capture and report trends · Batch and Submit Claims · Collaborate with other billing staff to address identified billing needs · Collaborate with Organizational Leadership regarding Payer contracts and training needs · Ensure all billing/claims issues are resolved prior to timely filing limits. Collaborate with Billing Supervisors and Organizational Leadership to address all problematic claims · Management of EHR data entries & claim write-offs · Perform other related tasks, as needed EDUCATION: · BA/BS Strongly Preferred JOB KNOWLEDGE, SKILLS & EXPERIENCE: · 3-5 years of billing & claims submission, collections and authorization experience · Experience in Behavioral Health Claims Preferred · Knowledge of Medical or Behavioral Health billing and insurance plans · Ability to perform arithmetic calculations associated with payments from Clients or insurance companies, including co-payments, coinsurance, & deductible • Skill in communicating professionally (in person, in writing, or on the phone) with insurance companies, providers and other staff • Ability to speak clearly and concisely, read, understand, and follow oral and written instruction • Ability to utilize medical billing software and financial ledgers • Ability to manage time efficiently Job Type: Full-time Pay: $23.84 - $28.71 per hour Expected hours: 40 per week Benefits: • Health insurance • Paid time off Work Location: In person