Medical Billing Specialist

4 weeks ago

Fort Myers, United States DNA Comprehensive Therapy Services Full time
Job DescriptionJob DescriptionDescription:

Come grow with us Elite DNA Behavioral Health is one of the largest providers of behavioral and mental health services in Florida – and we are expanding quickly We believe in providing high-quality, accessible care to our patients and a supportive environment that allows our team to grow professionally.


Our goal is to hire you – the best talent – to support our mission and allow you to grow with us.

We thrive on a mutual goal of providing excellent care to our patients through our comprehensive care services and collaborative culture. Elite DNA is the pioneer of the care coordination approach to mental health, where all patients are matched with their ideal services and providers prior to receiving direct care. Our team is at the forefront of providing leading-edge therapy services – from psychotherapy to psychiatry – to specialized programs such as psychosocial rehabilitation, EMDR, and group therapy.


Everything we do here at Elite DNA is guided by integrity and compassion for our patients and employees.


When you join the Elite DNA team, you will feel proud to be a part of the group that helps children, adults, and families in our communities live better lives.


Job Summary:

Elite DNA Behavioral Health is seeking to hire 2 full-time Billing Specialist to join our team in the Ft. Myers office.


Job Summary:
The Billing Specialist is responsible to provide support to providers, coworkers and customers internally and externally on billing related inquiries. The employee works/reviews all claims prior to their submission using department guidelines and Athena.



Responsibilities & Standards:

  • Demonstrate excellent interpersonal skills with patients, coworkers and insurance carriers.
  • Well-versed with all HIPAA Guidelines to ensure the protection of patient information from unauthorized inquiries.
  • Process and post payments when necessary
  • Works hold accounts in Athena within a timely manner
  • Resolve patient complaints within a minimal timeframe, same day whenever possible
  • Meet timelines for reprocessing Athena claims after updating the account with new information as provided by patients or physicians within the guidelines and timeframes permitted by the insurance carrier
  • Advanced knowledge of CPT codes and modifiers
  • Phones answered & voicemails returned within same day
  • Claim adjudication carrier rules knowledge
  • Conducts themselves in accordance with Elite DNA Therapy Services Policies and Procedures including the Code of Conduct
  • Meets or Exceeds monthly performance goals, expectations and reviews
  • Uses Paid Time Off effectively
  • Keeps overtime to a minimum/has any overtime approved by Director
  • Actively participates in team meetings and educational opportunities
  • Performs other duties as assigned.
  • Must be responsible for the assignment of accurate ICD diagnoses, CPT, HCPCS, and modifiers.
  • Able to abstract code from medical records, reports, and related patient documentation.
Requirements:

Education/Training Level:

  • Thorough knowledge of insurance carrier billing and reimbursement, CPT, modifiers and fee schedule differences.
  • Requires understanding of how to decipher explanation of benefits and explain the impact to the customer.

Licenses and Certifications: None

Communication Skills:

  • Proficient oral and written communications, and project management skills.
  • Excellent attention to detail, problem-solving and customer service
  • Ability to conduct telephone conversations with patients regarding account resolution and payment collection.
  • Must demonstrate positive interpersonal relationship skills with individuals and groups in a wide variety of settings
  • Insurance terminology knowledge essential

Technology Skills:

  • Effectively uses Electronic Health Records
  • Typing Skills

This position earns competitive compensation plus a full benefits package including medical, dental, vision, and life insurance, annual PTO of 15 days with tenure recognition incentives, one additional paid day for your birthday and Employee Assistance Program. We also offer opportunities for growth, as well as a great team atmosphere that empowers you to take ownership of outcomes in providing quality service and support.

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