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Billing Claims Specialist

3 months ago

Tuscaloosa, United States Indian Rivers Behavioral Health Full time
Job DescriptionJob Description

Billing Claims Specialist

Finance Department

Full-Time:40 hours

Monday-Thursday: 7:30am-5:00pm; Friday 8:00am-12:00pm

- Tuscaloosa, AL -

Competencies:

  • Excellent verbal, interpersonal and written communication skills.Must be able to communicate with consumers and families regarding consumer accounts.Must be able to effectively communicate with staff, other agencies, third party payers, etc.
  • Demonstrated competent computer skills.Accurate data entry skills required.
  • Must be able to organize, prioritize and manage a variety of tasks.
  • Working knowledge of standard business practices.
  • Ability to make decisions promptly and appropriately.
  • Ability to work cooperatively and effectively within the organization in order to serve the needs of agency operations.
  • Knowledgeable in cultural diversity.

Essential Functions/Responsibilities:

  • Prepares and submits clean claims to various companies either electronically or by paper.
  • Posts payments, adjustments, transfer of responsibility and refunds, as necessary.
  • Issues adjusted, corrected, and/or rebilled claims to insurance companies.
  • Denial and insurance follow-up management.
  • Identifies and resolves client billing problems.
  • Prepares, reviews, and sends client statements via U.S. mail.
  • Reviews accounts and makes recommendations to the Controller regarding non-collectable accounts.
  • Maintain a working knowledge of third party payers.
  • Participates in educational activities.
  • Answers questions from clerical staff and insurance companies.
  • Ensure that all assigned duties are implemented according to IRMHC policies and procedures.
  • Ensure all safety, fire prevention, and health measures are followed while on duty.
  • Interface in a professional manner with agency staff on an as needed basis to answer billing or insurance questions or to train or re-train staff as requested by the managers.
  • Assist in running error listings and following-up on responses from staff.
  • Assist in maintaining staff billability files.
  • Answer telephones for AR courteously. Handle calls and respond to messages in a timely manner.
  • Perform clerical duties, including, filing, faxing, and copying according to standard business practices and in a timely manner.
  • Work independently and/or with teams to complete assigned tasks accurately and in a timely manner with minimum supervision.
  • Attend all staff meetings as scheduled.
  • Perform job duties independently and practice efficient time management.
  • Maintain communication and awareness of current Organization events by reading memos, emails, bulletin boards, and communication logs.
  • Support Organizational Code of Conduct, Standards Compliance, HIPAA and Security Programs by ensuring job tasks are performed in a legal and ethical manner, assessing the work area for non-compliance and notifying the supervisor, manager, Executive Director or designee as appropriate, and maintaining training requirements and understanding that training is a required condition of employment.
  • Maintain the confidential nature of all consumer and Organization related activities by not divulging information outside the facility, discussing information within the facility on a need-to-know basis, acknowledging policy annually by signing confidentiality statement, and by referring media and general inquiries to the Executive Director.
  • Adhere to attendance and punctuality policy by allowing adequate time to arrive, clock-in and assume responsibilities at designated time, adhering to meal and break times and making timely requests for annual leave and reporting the need for sick leave in accordance with policy.
  • Demonstrate the skills necessary to keep the business operations of Indian Rivers on task and up-to-date.
  • Devote 40 hours per week to the completion of duties as outlined in the job description.More than 40 hours of work per week may be required to meet job responsibilities and deadlines.
  • Comply with all standards related to safety and health by maintaining current TB Test, CPR/First Aid, CPI, and by reporting infections and on-the-job injuries in accordance with policy.
  • Identify opportunities for improving the quality of services provided by the department and the organization.
  • All other job duties and responsibilities as requested by the supervisor or Executive Director.

Minimum Qualifications:

  • HighSchoolDiploma or equivalentrequired
  • Bachelor's or Associate's degree preferred
  • Must be able to read, write legibly, speak, and comprehend English.
  • Current Alabama driver's license and good driving record as defined by Indian Rivers' policy.

Working Conditions, HIPAA, Other Guidelines:

Job Specifications: To perform this job successfully, an individual must be able to perform each primary duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations maybe made to enable individuals with disabilities, who are otherwise qualified to perform the essential functions.

HIPAA: Must be knowledgeable of and abide by HIPAA regulations regarding protected health information as defined by HIPAA and IRBH. Minimally accesses verbal, written, and /or electronic PHI, usually incidentally to an approved use and /or disclosure as pertains to consumer's financial, demographic, and/or clinical data.

Working Conditions: Works in general office environment and in residential facilities; may require long hours. Must have the use of sensory skills in order to effectively communicate and interact with other employees and the public through the use of the telephone and personal contact. Physical capability to effectively use and operate various items of office related equipment, such as, but not limited to, computer, copier, multi-line phone and fax machine. Some risk involved in the event of aggressive/out-of-control consumers.Must possess a valid Alabama driver's license.

Physical Requirements: The Physical Requirements described herein are representative of those which must be met by an employee to successfully perform the primary functions of this job. Reasonable accommodations maybe made to enable individuals with disabilities, who are otherwise qualified, to perform primary functions.

Physical presence onsite is essential. Hearing and vision must be normal or corrected to within normal range. Able to perform the duties with or without reasonable accommodation.

Full-Time Employee Benefits:

  • Blue Cross Blue Shield Medical Insurance
  • Employees Retirement System of Alabama
  • Prescription Drug Coverage
  • Mileage Reimbursement
  • Paid Time Off
  • Voluntary Dental, Vision, and Life Insurance

Indian Rivers is an Equal Opportunity Employer
This Employer participates in E-Verify