Billing Specialist

Billing Specialist Job Description

Job Overview: Process and submit client insurance billing

Work Schedule: Monday – Friday, 8:00 AM – 4:00 PM

Employee Classification: Hourly, Full-time

Qualifications: High school diploma or higher. Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Publisher, Access), Google Business Suite. Experience with database software such as Central Reach is a plus.

Essential Responsibilities: The primary duties of the position include:

Billing

• Prepare, review and bill claims via Central Reach/OfficeAlly, NCTracks Portal

• Check claim status on appropriate payors systems and contact insurance as needed

• Resolve denials for unpaid and rejected claims, follow up on outstanding claims and adjust accordingly

• Send medical records and other documentation to payors, as requested

• Review timesheets and billing entries in Central Reach to ensure accurate information

• Post payments (electronic and manual) in billing software

• Collaborate as needed to ensure all requirements are obtained for timely enrollment of clients and submission for authorizations

Authorizations:

• Collaborate to ensure timely and accurate verification of client’s ABA benefits eligibility through primary and secondary payers

• Gather and submit required documentation to gain authorization for ABA services, following up within the agency as necessary

• Send requested information to insurance carriers, as needed

• Foster relationships with payor partners, follow-up on submitted authorization requests

• Monitor and report on the status of authorization requests and issues

• Work with the leadership to ensure timely completion of documentation

Practice Management Software:

• Manage client accounts, upload documentation required for billing, add payers, connect clients to providers and service codes, fee schedules, etc.

• Perform weekly billing audit, screen for non-billable time, code overlaps, schedule inconsistencies, code requirements and MUEs

• Document insurance billing related correspondence in the appropriate location, for example: calls and relevant/important information

• Scan documents such as authorization letters, EOB's, correspondence from payers and upload into practice management software

• Assist leadership with updating billing software with rate changes

• Contact Central Reach to resolve any issues

Other:

• Track and report back any missing materials for insurance onboarding to appropriate departments

• Attend webinars and report back to relevant parties as directed

• Follow HIPAA regulations when handling all patient information