SUD Biller

Position Title:            SUD Biller

Department:              Substance Use Disorder

Position Reports to:  Program Director

Position Summary:

Enters Drug Medical/MHLA billing daily in SAGE software, Review’s medical SUD charts insuring all services are billed/finalized and accounted for, insure units are entered and maximized. Audits Substance Use disorder records to insure billing is maximized and reports to Program Director billing issues and productivity. Tracks clinical staff’s daily progress and reports numbers to Program Director weekly as requested.  Continually communicates with program staff to insure all billable are accounted for and continually entered. Tracks and collects needed approvals and signatures from Clinical Staff to insure continuous and optimal reimbursement.

Responsibilities:

• Process all services and billing daily for current month
• Input client authorizations and justifications as needed
• Finalize draft billing to insure that it will be ready for process at the Directors request
• Track and report staff billing every 48 hours to Program Director
• Attend provider meetings regarding billing to be updated on new rules and requirements to stay in compliance
• Obtain Medical Director’s signatures for billing purposes
• Enter and retrieve patient medical data from SAGE electronic health record’s System updating entries as necessary; audit SUD chart for accuracy and completeness, note deficiencies and refer for appropriate follow up and completion.
• Correct denial of billing as needed
• Communicate with SAPC to make requested changes and provide requested information
• Consult with physicians, clinical staff and other personnel on practices and conventions to provide detailed information or gather additional documentation; maintain comprehensive records of all communications regarding suggested changes.
• Research and initiate activity to resolve denials and billing issues, review difficult situations to determine the most appropriate steps.
• All denials need to be investigated and follow up notes entered and corrected
• Assist patients on program eligibility and on billing information.

Observes CMOAR Appearance/Dress Standards.

• Observe regulations on time card use and reporting.
• Maintain attendance as a policy.
• Maintain a clean and safe work area.
• Observe general Safety/Employee Health policies and procedures.
• Maintain a current annual health screening.
• Observe CMOAR Appearance/Dress standards.
• Maintain the privacy and confidentiality of both client and employee with regard to medical records.
• Display clearly visible identification.
• Treat all patients with respect and dignity and adheres’ to the Patient Bill of Rights.
• Treats all employees with respect and dignity in accordance to non-discriminatory policy and procedure.
• Treat all employees/clients in a courteous and professional manner.
• Conduct only work related conversations when clients are waiting for service.
• Do not discuss other staff members, policies, problems or SUD department in public areas of clinic.

Qualifications/Requirements:

• Highs School graduate or equivalent.
• Knowledge of Confidentiality and rules regarding HIPAA and State and Federal governing release of medical information required
• Some knowledge of SUD billing practices and program preferred.
• Task and detail orientated
• Maintain County C number and NPI number up to date preferred but not required