UNKNOWN

FEED

HOUR

Utilize InSync’s reports, dashboards, and tools to analyze and track billing data, claims productivity, and monitor the revenue cycle from claim generation to claim payment, improving processes where needed. · 2+ years of outpatient professional behavioral health billing experience; MAT and OBOT/OBAT service billing (fee-for-service and bundle charges) experience is preferred but not required.

Job Description: Behavioral Health Billing SpecialistLocation: Johnson City, TN Headquarters Key Responsibilities: ·         Accurately prepare and submit claims for various services rendered across all facilities.·         Regularly review patient financials to assure claims are processed accordingly. ·         Analyze and address claim denials, rejections, and underpayments, and take corrective actions to resolve issues.·         Generate claims for all complete, accurately documented encounters.·         Reviews clinical documentation against claim information prior to claim submission. Identifies documentation discrepancies and/or deficiencies and reports them accordingly for correction in accordance with NLM’s clinical documentation integrity and compliance standards.·         Queries supervisor with any questions or uncertainties.·         Verifies and updates insurance information and/or patient demographic information as required to ensure claims submitted are clean, error-free claims.·         Reviews providers’ selection of CPT and ICD-10 codes for accuracy to assure clean claim submission.·         Ensures billing compliance with federal, state, and payer-specific guidelines, including Medicaid, Medicare, and commercial insurance.·         Utilize appropriate ICD-10-CM, CPT, and HCPCS codes for services provided.·         Communicate and collaborate with the revenue cycle team to ensure proper coding and documentation for all services rendered. Our RCM team strives to provide staff with the education, materials, and tools necessary to carry out their roles effectively and efficiently.·         Stay up to date with regulatory changes in billing practices, payer policies, state and federal laws, and reimbursement methodologies, particularly as they pertain to addiction treatment and integrated services.·         Utilize InSync’s reports, dashboards, and tools to analyze and track billing data, claims productivity, and monitor the revenue cycle from claim generation to claim payment, improving processes where needed.·         Provide support in auditing and quality assurance processes to ensure billing accuracy and data integrity.<a name="_Hlk157597625">·         Work closely with RCM staff to resolve billing issues and optimize revenue cycle processes.</a>·         Contributes to the development and implementation of best practices for billing processes, working to streamline workflows and increase efficiency within the billing department.·         Assist with relevant projects and assignments, as requested. Qualifications: ·         2+ years of outpatient professional behavioral health billing experience; MAT and OBOT/OBAT service billing (fee-for-service and bundle charges) experience is preferred but not required·         Certified Professional Biller (CPB), Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) preferred but not required·         High school diploma or equivalent; additional education in medical billing, coding, or healthcare administration is a plus.·         Excellent analytical, problem-solving, and communication skills.·         Ability to work independently and collaboratively in a team environment.·         Detail-oriented with a high degree of accuracy in data entry and financial analysis.·         Proficiency with EMR systems and billing/practice management software required ·         Knowledge and experience with InSync EMR/PM a PLUS·         Flexible and easily adaptable to change Benefits<ul><li>Medical, Vision, Dental</li><li>PTO</li><li>401k</li><li>EAP</li><li>Travel Assistance</li><li>Weekends Closed</li></ul>

New Life Medicine, PLLC

Billing Specialist (Medical Industry)

Analysis Skills

Auditing

Behavioral Health

Best Practices

Billing

Certified Coding Specialist (CCS)

Certified Professional Coder (CPC)

Communication Skills

Corrective Action

Current Procedural Terminology (CPT)

Data Entry

Data Quality

Demographics

Detail Oriented

Documentation

Electronic Medical Records

Federal Laws and Regulations

Financial Analysis

Healthcare

Healthcare Administration

Healthcare Common Procedure Coding System (HCPCS)

High School Diploma

ICD-10

Insurance

Maintain Compliance

Medicaid

Medical Billing

Medical Coding

Medical Records

Medicare

Outpatient Care

Practice Management Software

Problem Solving Skills

Process Improvement

Quality Assurance Methodology

Regulations

Reimbursement

Reporting Dashboards

Staff Training

State Laws and Regulations

Gethired

OTHER

Knowledge of medical terminology preferred · Basic computer proficiency · Typing speed: minimum 40 WPM · Familiarity with CPT and ICD-9 coding is helpful · Good written and verbal communication skills are essential for account follow-up. office responsibilities related to patient accounts, including charge import, diagnostics and procedural coding, and claim follow-up with third-party payers to achieve a zero-balance resolution.

Overview:
Under general supervision, the Hospital Billing and Follow-Up Specialist handles essential billing and insurancefollow-up functions. This role requires a fundamental understanding of insurance claim processing, knowledgeof UB and HCFA claim forms, and the ability to interpret insurance explanation of benefits (EOBs), handledenials, and perform follow-up with insurers to ensure claims resolution. The position encompasses businessoffice responsibilities related to patient accounts, including charge import, diagnostics and procedural coding,and claim follow-up with third-party payers to achieve a zero-balance resolution.

Special Instructions:
This position has to possibility of being remote after 6 months, per managers discretion

Responsibilities:
Promote the mission, vision, and values of the organization· Import charges from queues in a timely manner and append modifiers or any requiredinformation for claim transmission· Review daily accounts that are ready to be billed in Waystar from Meditech· Initiate correction on all claims with errors by the designated time· Follow up on any correspondence that may have been received on that day or theprevious day· Cross train on billing all lines of business to the different payers· Pull listing of all accounts assigned to be follow up by specific payer· Diagnostic and procedural codingFollow-Up Responsibilities· Responsible for the resubmission of primary, secondary, and tertiary claims per respective regulations andpolicies.· Communicate with third-party representatives as necessary to complete claims processing and /or resolveproblem claims.· Follow-up daily on post processing activity including but not limited to, rejected billings, adjustments, andrebilling, and denied claims for accounts.· Maintain accounts receivable detail of their accounts through tasking.· Maintains standards per payer for percentage accounts >90 days.· Works minimum standard number of accounts per payer per day.· Meets or exceeds collection goals by payer each month.· Works all assigned accounts as assigned, depending on balance.· Participates in educational activities and attends monthly department staff meetings.· Maintains confidentiality: adheres to all HIPAA guidelines/regulations.· Other duties as assigned from time to time.· Attend educational activities and monthly department staff meetings· Perform other duties as assigned 

Qualifications:
Education· High School Diploma or GED Minimum Work Experience· Six months previous experience in hospital registration, billing and collections, financial counseling, or customer service preferred Required Skills, Knowledge, and Abilities· Knowledge of medical terminology preferred · Basic computer proficiency · Typing speed: minimum 40 WPM · Familiarity with CPT and ICD-9 coding is helpful · Good written and verbal communication skills are essential for account follow-up

Appalachian Regional Healthcare, Inc.

Hospital Billing Specialist

Accounts Receivable

Accounts Receivable Management

Centers for Medicare and Medicaid Services (CMS)

Claims Processing

Computer Skills

Credit and Collections

Customer Support/Service

Exceeded Sales Goal

HIPAA (Health Insurance Portability and Accountability Act)

Hospital Administration

ICD-9

Insurance Documentation

MEDITECH

Medical Terminology

Presentation/Verbal Skills

Third-Party Payer

Time Management

Typing

Writing Skills

[AW]-iCims

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Billing Specialist (Medical Industry)New Life Medicine, PLLC

Hospital Billing SpecialistAppalachian Regional Healthcare, Inc.

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