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Claims Processing Specialist

2 months 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 inquiries and collaborating effectively with colleagues and external partners.
  • Proficient in computer operations with a strong emphasis on accurate data entry.
  • Ability to prioritize and manage multiple tasks efficiently.
  • Familiarity with standard business protocols.
  • Quick and sound decision-making skills.
  • Team-oriented with a focus on organizational objectives.
  • Understanding of cultural diversity and its implications in the workplace.

Primary Responsibilities:

  • Prepare and submit accurate claims to various insurance providers, both electronically and via paper.
  • Process payments, adjustments, and refunds as necessary.
  • Issue corrected claims to insurance entities as required.
  • Manage denial follow-ups and insurance inquiries.
  • Identify and resolve billing discrepancies for clients.
  • Prepare and dispatch client statements through traditional mail.
  • Review accounts and advise management on uncollectible accounts.
  • Maintain up-to-date knowledge of third-party payer requirements.
  • Engage in ongoing educational initiatives.
  • Provide support to clerical staff and insurance representatives.
  • Ensure compliance with organizational policies and procedures.
  • Adhere to safety and health regulations while on duty.
  • Collaborate 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 records.
  • Handle incoming calls for accounts receivable courteously and efficiently.
  • Perform administrative tasks, including filing, faxing, and copying, in a timely manner.
  • Work independently or as part of a team to complete assignments accurately and promptly.
  • Attend scheduled staff meetings.
  • Demonstrate effective time management in job performance.
  • Stay informed about organizational updates through memos and communications.
  • Support compliance with the Organizational Code of Conduct and HIPAA regulations.
  • Maintain confidentiality regarding consumer and organizational matters.
  • Follow attendance and punctuality guidelines.
  • Contribute to the operational efficiency of the organization.
  • Commit to a 40-hour work week, with potential for additional hours as needed.
  • Comply with health and safety standards, including maintaining necessary certifications.
  • Identify opportunities for enhancing service quality within the department.
  • Perform additional duties as assigned by 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.

Work Environment:

This position requires a presence in an office setting and may involve extended hours. Effective communication skills are essential for interaction with colleagues and the public. Physical capability to operate office equipment is necessary. Some risk may be present when dealing with challenging consumer situations.

Physical Requirements: The role necessitates the ability to meet the physical demands associated with job responsibilities, with reasonable accommodations available for qualified individuals.

Employee Benefits:

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

Indian Rivers Behavioral Health is an Equal Opportunity Employer.