Billing Specialist

Job description

Billing Specialist

ABC Behavior Therapy, LLC (ABC) is a child and family-centered ABA agency seeking a Billing and Coding Specialist (BCS) to assist with entering, uploading and coding patient services. The Specialist will be responsible for generating invoices to be sent to the patient. They will also sort and file paperwork, handle insurance claims, and perform collections duties. Within the scope of these duties, the BCS will also assist with coordination of patient services as needed. This position serves to ensure compliance with requirements of funding sources which thereby protects patients against unforeseen interruptions in services.

Duties and Responsibilities:

Translate patient information into alphanumeric medical code for reporting purposes if applicable
Submit claims and process payments
Verify eligibility, benefits, and patient responsibility for new clients and current clients on a semi annual basis. Review & edit ICD 10 diagnosis codes in patient charts as needed
Code patient services and enter into the data collection system
Enter Calendar sessions on accupoint
Conduct bi-weekly audits to ensure claims processed
Create folder to show timely filings for each insurance
Appeal Process if needed
Design and maintain spreadsheets for collection purposes.
Transform billing data into charts, graphs or other useful data for Administrative review
Monitor Patient Accounts- Follow up on accepted/denied claims &  investigate rejected claims
Patient Care Coordination
Collect, post, and manage patient account payments to include sending patient invoices to families
Prepare and review patient statements and EOBs
Review delinquent accounts and contact families for collection purposes and/or payment plans
Complete Fee Agreement contracts for families (initial, bi-annual, and annual)
Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding
Reach out to referring doctor’s office as needed to confirm diagnosis and updated referrals yearly
Create NPI Numbers for new staff
Ensure that authorizations for patients are updated
Submit new authorization requests for new and continuing clients
Create folders to track what is needed for each insurance company
Reconcile employee benefits to ensure accuracy and make proper payments (medical, dental and AFLAC)
Update ADP with employee deductions for training, medical and dental deductions
Accupoint/Catalyst
Pull notes from Catalyst to enter into Accupoint weekly
Input New employees into Accupoint- enter NPI
Create base schedule for clients into accupoint so notes sync
Complete Quarterly Audits/ Develop system

Job Qualifications:

Required:

High school diploma or equivalent
Minimum of 2 years of billing experience
Proficiency with computers and medical billing software
Knowledge of unfair debt collection practices and insurance guidelines
Understanding of primary code classifications: ICD-10-CM, ICD-10-PCS, CPT and HCPCS
Understanding DSM -5 and/or ICD-10 Diagnostic Codes
Understanding of Timely filing Requirements per insurance company
Communication skills with patients/healthcare companies
Strong written and verbal skills
Great Time Management Skills; Multitasker
Thorough knowledge of health care benefits and insurance regulations.
Preferred:

A Bachelor’s degree in healthcare administration or health information management
Successful completion of the CPC Certification Exam
Basic accounting and bookkeeping practices