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Billing Specialist

3 months ago

Chattanooga, United States Siskin Children's Institute Full time
Job DescriptionJob DescriptionDescription:

Job Type: Full-time position

Days/Hours: Monday - Friday / 8a to 5:30p (EST)


The Billing specialist supports all aspects of the revenue cycle including reviewing, posting and managing account payments, submitting claims and following up with insurance companies, obtaining referral and payor authorizations to ensure timely payment of claims and working with families to address billing and insurance questions.

Requirements:

QUALIFICATIONS:

High school graduate or GED equivalent required. Two to three years of medical billing experience required. Applied Behavior Analysis (ABA) billing HIGHLY PREFERRED. Demonstrate excellent customer service attitude/behavior. Demonstrated proficiency in: multi-tasking; flexibility; time management; organization, attention to detail; scheduling; professionalism; quality focus. Functions well in a team focused environment. Demonstrate independent problem solving and critical thinking abilities. Electronic health records (EHR) experience a plus, preferably in Central Reach. Demonstrated computer skills including but not limited to: MS Word and Excel, E-Mail, 10 Key.

JOB REQUIREMENTS:

  • Has experience with and maintains knowledge of third party payer rules as related to medical and therapy billing including precertification and authorization
  • Ability to communicate effectively with insurance companies, patients/families and coworkers to obtain billing department goals and objectives
  • Strong attention to detail and accuracy in all areas of revenue cycle
  • Has knowledge and experience in all aspects of revenue cycle including registration, scheduling, cash management and reconciliation, verifying eligibility, etc.
  • Excellent typing and computer skills including billing software, Microsoft office, and other related medical billing products as needed
  • Ability to manage multiple tasks and apply critical thinking and prioritization skills in a fast paced environment

ESSENTIAL FUNCTIONS:

  • Run eligibility on every patient scheduled for all providers on every visit. (Make note in EMR)
  • Get authorizations on all medical visits that require authorizations at least two weeks in advance. (Add auth. # to EMR in Auth section)
  • Daily follow up on outstanding authorizations with required resolution prior to visit.
  • Obtain authorizations for Therapy (OT & PT) after evaluation, with detailed notes in EMR
  • Phone calls to patients if their insurance will not cover future services (i.e. Therapy).
  • Tracking method for approved Therapy visits that need re-auth.
  • Retrieving and uploading accurate insurance information of EVERY patient prior to appointment.
  • Provide daily spreadsheet to front desk showing patient’s copay amount and any outstanding balances. Keep at least two weeks out on shared drive.
  • Maintain patient A/R spreadsheet updated with daily calls, financial consultations before appointments, payments plan contracts and collections review grouping.
  • Work patient A/R- Phone call protocol, letter protocol & collections account preparation.
  • Resubmitting and/or appealing denied claims with payer.
  • Follow up on denied claims work queue in billing system.
  • Review schedules for add on patients to ensure appropriate eligibility and authorizations.
  • Supports front desk operations as needed. Works positively and collaboratively will all members of Center and Siskin Children’s Institute Management and staff.
  • Performs other duties as assigned