Senior ABA Billing Representative

STEPS Behavioral Health is an Applied Behavior Analysis (ABA) therapy company comprised of Board-Certified Behavior Analysts (BCBAs), Behavior Technicians, and a strong administrative team who work together to provide ABA Therapy for individuals with autism spectrum disorder (ASD). We also support families in need of social work services to assist with helping raise their families and handle the challenges of life with a child with a disability. We are currently seeking a Senior Medical Billing Specialist. This is a full time position working 40 hours a week Monday-Friday.

Job Summary: As a Senior Medical Billing Specialist, you will play a vital role in ensuring the efficient processing and submission of medical claims for reimbursement. You will oversee the billing and accounts receivable process and a team of medical billing specialists to ensure accuracy, compliance with regulations, and timely submission of claims. Your responsibilities will include analyzing medical records, assigning appropriate billing codes, submitting claims, verifying insurance coverage, processing ERAs and EOBs from insurance, and communicating with insurance companies and healthcare providers to resolve billing issues. Your expertise in medical billing practices and regulations will be crucial in optimizing revenue cycle management to ensure timely claim payment and maintain financial stability for the organization.

Key Responsibilities:

1. Supervise and coordinate the activities of the medical billing team to ensure efficient operations.
2. Verify patients' insurance coverage and eligibility for services.
3. Scrub billing claims before submission to catch errors and ensure they meet insurance guidelines and are eligible for payment.
4. Prepare and submit accurate and timely medical claims to insurance companies, government agencies, and other payers.
5. Follow up on unpaid or denied claims, researching, and resolving billing discrepancies and claim rejections.
6. Collaborate with healthcare providers and clinical staff to ensure proper documentation and coding practices for maximum reimbursement.
7. Stay updated on changes in medical billing regulations, coding guidelines, and insurance policies to ensure compliance and mitigate risks.
8. Conduct regular audits and quality assurance checks to monitor billing accuracy and identify areas for improvement.
9. Train and mentor entry level billing staff, providing guidance on coding protocols, billing procedures, and industry best practices.
10. Generate reports and metrics to track key performance indicators (KPIs) related to billing efficiency, revenue collection, and accounts receivable management.
11. Serve as a resource for internal stakeholders, answering questions and providing guidance on billing-related matters.
12. Participate in meetings and cross-functional teams to support organizational goals and initiatives related to revenue cycle management and financial performance.

Qualifications:

1. Experience: Proven experience (3-5 years) in medical billing and coding with a focus on complex billing scenarios and insurance claim resolution.
2. Certification: Certified Professional Biller (CPB) or Certified Professional Coder (CPC) credentials preferred.
3. Technical Skills: Proficiency in medical billing software and electronic health records (EHR/EMR) systems, as well as familiarity with Microsoft Office Suite. Prefer experience with Tebra.
4. Knowledge: In-depth understanding of medical billing terminology and healthcare reimbursement methodologies.
5. Analytical Skills: Strong analytical and problem-solving skills to interpret complex billing guidelines and resolve billing discrepancies.
6. Communication: Excellent communication skills, both written and verbal, to interact effectively with administrative and clinical staff, insurance companies, and clients.
7. Attention to Detail: Meticulous attention to detail to ensure accuracy in coding, billing, and documentation.
8. Teamwork: Ability to collaborate with cross-functional teams including administrative and clinical staff and other billing professionals.
9. Adaptability: Flexibility to adapt to changing regulations, technology updates, and organizational priorities in the industry.
10. Ethical Conduct: Commitment to upholding ethical standards and maintaining patient confidentiality in all aspects of billing operations.

The Senior Medical Billing Specialist plays a critical role in ensuring the financial health of healthcare organizations by effectively managing the billing process and optimizing revenue collection.

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