Billing Specialist

Position Summary

Perform all billing functions necessary to support reimbursement activities. Duties to include any or all of the following:  timely billing and invoicing of services; timely posting of remittances; identification and resolution of denied and partially paid claims; support or coordination of the authorization process.  This position requires strong computer skills with a focus on computerized billing systems and accurate data entry.  Attention to funding source requirements, timeliness and dependability are required.

Essential Roles and Responsibilities

1. Prior to processing billing runs, generate reports to identify services with potential billing issues and notify programs of necessary corrections.
2. Verification of client funding sources and eligibility
3. Book services in the billing system as soon as possible after operational staff enters and approves notes.
4. Generate invoices, electronically, and submit to funding sources timely.
5. Post electronic and manual remittances in the billing system within 5 days.
6. Review remittance advice for rejections and notify program staff for necessary corrections.
7. Rebill all denied or partially paid services within 7 days.
8. Provide Billing Supervisor with open balance reports at a frequency to be determined by the Billing Supervisor
9. Identify needed actions needed for payment of open claims.
10. Work in collaboration with other Billing Specialists and with the Billing Supervisor to identify ways in which claims can be processed more efficiently and paid sooner.
11. Communicate with funding source contacts to develop relationships that support Pressley Ridge’s ability to be paid for services provided.
12. Coordinate or support the authorization process as needed.
13. Maintain complete and orderly files.
14. Maintain security of all client records according to HIPPA standards
15. Professional growth and development through relevant training
16. Special projects as assigned.   

Minimum Qualifications

• Education/Credentials/License.  High School Diploma. Associate degree in accounting or specialized medical coding coursework preferred.
• Experience -Three years previous experience in billing related functions.
• Technical Skills.  Proficiency with office computer software programs
• Must be able to obtain clearances - State Police, FBI, and Child Abuse Clearances; CPSL Mandated Reporter-Recognizing and Reporting Child Abuse training per state regulation.

Working Conditions

• Physical Demands - Vision, speech, and hearing.
• Working hours - 40 hours traditional work week.