Billing Specialist I

2 weeks ago

Washington, United States Ideal Option and Ideal Balance Full time

Position Overview:

We are seeking a dedicated Billing Specialist to join our dynamic team at Ideal Option. This role is crucial in supporting our financial operations by managing the billing process effectively.

Key Responsibilities:

  • Submit medical claims to various insurance providers, including Medicare and Medicaid.
  • Collaborate with insurance companies, healthcare professionals, and patients to ensure timely claim processing.
  • Review and address unpaid or denied claims through appeals.
  • Process patient and insurance refund requests promptly and accurately.
  • Assist patients in obtaining necessary information for charity applications or payment plans.
  • Utilize coded data to generate and submit claims to insurance entities.
  • Stay updated on current billing regulations and trends through continuous education.
  • Support patients in verifying their benefits and assist with scheduling and account setup.
  • Ensure departmental goals are achieved on a weekly, monthly, and quarterly basis.
  • Utilize eCW and various payer portals effectively.
  • Manage referrals and pre-authorizations as needed for medical procedures.
  • Verify eligibility and benefits for treatments and hospitalizations.
  • Review patient invoices for accuracy and completeness, addressing any discrepancies.
  • Prepare and transmit claims using billing software, both electronically and via paper.
  • Follow up on outstanding claims within the standard billing cycle.
  • Ensure insurance payments are accurate and comply with contractual agreements.
  • Identify secondary or tertiary insurance billing requirements.
  • Establish patient payment plans and manage collection accounts.
  • Update billing software with any rate changes and maintain cash spreadsheets.
  • Adhere to HIPAA regulations and the Privacy Act at all times.

Ideal Candidate Profile:

The successful candidate will possess strong interpersonal and communication skills, both verbal and written. A professional demeanor, excellent attendance, and the ability to work independently are essential. Problem-solving skills are highly valued.

Qualifications:

  • At least one year of experience in medical billing.
  • High School Diploma or GED.
  • Proficiency in Microsoft Office Suite and internet navigation.
  • Knowledge of chemical dependency and its impact on individuals and communities is preferred.

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