Claims Processing Specialist

1 week ago

Tuscaloosa, Alabama, United States Indian Rivers Behavioral Health Full time
Job Overview

Position Title: Billing Claims Specialist

Department: Finance

Employment Type: Full-Time (40 hours per week)

Key Competencies:

  • Exceptional verbal, interpersonal, and written communication abilities. Capable of engaging with clients and families regarding account details and collaborating effectively with staff and external entities.
  • Proficient computer skills with a focus on accurate data entry.
  • Adept at organizing, prioritizing, and managing multiple tasks efficiently.
  • Familiarity with standard business operations.
  • Quick and sound decision-making skills.
  • Ability to work collaboratively within the organization to fulfill operational needs.
  • Understanding of cultural diversity and its implications in the workplace.

Primary Responsibilities:

  • Prepare and submit accurate claims to various insurance providers, utilizing both electronic and paper methods.
  • Process payments, adjustments, transfers of responsibility, and refunds as required.
  • Issue corrected and rebilled claims to insurance companies as necessary.
  • Manage denial and insurance follow-up processes effectively.
  • Identify and resolve billing issues for clients.
  • Prepare, review, and dispatch client statements through traditional mail.
  • Evaluate accounts and provide recommendations to management regarding uncollectible accounts.
  • Maintain up-to-date knowledge of third-party payers.
  • Engage in ongoing educational activities to enhance professional skills.
  • Respond to inquiries from clerical staff and insurance representatives.
  • Ensure compliance with organizational policies and procedures in all assigned tasks.
  • Adhere to safety, fire prevention, and health protocols while on duty.
  • Interface professionally with agency staff to address billing or insurance inquiries and provide training as needed.
  • Assist in generating error reports and following up on staff responses.
  • Support the maintenance of staff billing files.
  • Handle telephone inquiries for accounts receivable courteously and efficiently.
  • Perform clerical tasks such as filing, faxing, and copying in a timely manner.
  • Work independently or as part of a team to complete tasks accurately with minimal supervision.
  • Attend scheduled staff meetings and contribute to discussions.
  • Demonstrate effective time management skills while performing job duties.
  • Stay informed about current organizational updates through memos, emails, and bulletin boards.
  • Uphold the organization’s Code of Conduct, compliance standards, and security programs by performing tasks ethically and legally.
  • Maintain confidentiality regarding all consumer and organizational matters, sharing information only on a need-to-know basis.
  • Follow attendance and punctuality policies diligently.
  • Contribute to the efficient operation of Indian Rivers by ensuring business tasks are completed on time.
  • Devote the necessary hours to fulfill job responsibilities, which may exceed 40 hours per week.
  • Comply with health and safety standards, including maintaining current certifications.
  • Identify opportunities for enhancing service quality within the department and organization.
  • Perform additional duties as assigned by supervisors or management.

Minimum Qualifications:

  • High School Diploma or equivalent required.
  • Bachelor's or Associate's degree preferred.
  • Proficient in reading, writing, and speaking English.
  • Valid driver's license with a clean driving record as per organizational policy.

Working Conditions:

This position requires effective communication and interaction in an office environment and may involve extended hours. Employees must possess the physical ability to operate office equipment and manage various tasks while ensuring safety and compliance with organizational standards.

Employee Benefits:

  • Comprehensive medical insurance.
  • Retirement plan options.
  • Prescription drug coverage.
  • Mileage reimbursement.
  • Paid time off.
  • Optional dental, vision, and life insurance.

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

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