Billing Specialist

5 days ago


Miami FL USA, United States Promises Behavioral Health, LLC Full time
Job Summary

We are seeking a highly skilled Billing Specialist to join our team at Promises Behavioral Health, LLC. As a key member of our Business Office, you will be responsible for ensuring the accurate and timely submission of medical claims to various insurance companies and payers.

Key Responsibilities
  • Claims Submission: Submit clean claims per billing frequency as assigned by management, ensuring compliance with payer billing guidelines.
  • Facility Support: Assist with the coverage of other facilities as needed, maintaining accurate and specific billing guidelines.
  • Charge Reconciliation: Reconcile charges in the patient accounting system to ensure all billable charges are captured and submitted within the appropriate time frame.
  • Rebill Requests: Handle rebill requests and assist with billing projects as assigned.
  • Billing Edits: Review and correct billing edits in Waystar to ensure claims are released for submission.
  • Month-End Close: Assist in month-end close processes.
  • Managed Care Knowledge: Be knowledgeable of all managed care organizations (MCOs).
  • Professional Growth: Accept responsibility for professional growth and development of self.
  • Performance Improvement: Support facility-wide performance improvement goals and objectives.
Requirements
  • Education: A high school diploma or an equivalent combination of education, experience, and training that provides the required knowledge, skills, and abilities.
  • Experience: Experience within the Behavioral Health industry is required. Five (5) years of Business Office experience preferred, with at least two (2) of those years involving healthcare office management. One (1) year of experience in a billing practice, including exposure to verification, certification, authorization, managed care, revenue capture, and relationship building with payers.
  • Knowledge/Skills/Abilities: Knowledge of medical terminology and an ability to accurately record payables, receivables, collections, and data related to operations of the facility. Excellent oral and written communication in English, ability to perform routine numerical calculations for compiling various reports, and ability to exercise good judgment and discretion in all interpersonal contact.


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