Reconcile bed utilization charts with billing spreadsheets to ensure accuracy and consistency.
Run eligibility verifications (EMEVS) for potential outpatient admissions and communicate funding information to admissions staff.
Verify insurance eligibility and update client insurance information within KIPU as needed.
Conduct monthly eligibility checks for all outpatient clients and update records accordingly.
Identify and communicate changes in client funding sources.
Maintain and update outpatient billing spreadsheets on a weekly basis using attendance records.
Track outpatient authorizations and notify counselors of upcoming authorization expirations.
Add Vivitrol services to appropriate Fee-for-Service authorizations.
Prepare and submit outpatient Medicaid and Fee-for-Service claims.
Reconcile Medicaid and Fee-for-Service payments and correct billing discrepancies.
Post Medicaid remittance payments to utilization tracking spreadsheets.
Assist with back-billing of Medicaid claims as needed.
Process and track state-funded Uber transportation reimbursements.
Generate and send client deductible and co-payment invoices.
Provide billing coverage for Detox and Residential Billing Specialists during absences.
Maintain confidentiality and compliance with all HIPAA, state, federal, and organizational requirements.
Perform other duties as assigned.
Knowledge, Skills, and Abilities:
Understanding of healthcare insurance verification and authorization processes.
Knowledge of Medicaid billing regulations and reimbursement procedures.
Ability to analyze billing data and resolve discrepancies.
Strong problem-solving and critical-thinking skills.
Ability to work independently and collaboratively within a team environment.