Job Description

Medical Billing & Collections Specialist

The medical billing and collections specialist position reports to the Billing Director. The role manages, monitors and ensures the execution of the billing and collections for all services rendered by the Facilities. The position is responsible for making sure that services rendered are billed correctly, accurate records are maintained, bills are processed and collected expeditiously and reports are produced on a timely basis showing status of processed and pending bills. In this role ongoing attention to regulatory changes in Medicaid and other public assistance programs as well as in establishing and maintaining a close working relationship with the appropriate contact personnel is essential.

Position Summary:

• Compile, monitor and bill out claims.
• Verify client's insurance benefits on an ongoing basis.
• Performs financial transactions including verifying, classifying, posting and recording accounts receivable data.
• Work error reports from billing system.
• Notify unit CBAs via phone calls, emails or both of any changes in client's Medicaid/Child HealthPlus or insurance benefit status as well as counseling staff/supervisors.
• Stay current on regulatory changes related to Medicaid, Child Health Plus and other insurances that may impact billing and the billing system...address these changes with the billing system administrator and with affected staff/managers.
• Upload electronic payments and apply to clients' accounts.
• Work denials to reduce the amount reflecting on the Aging report.
• Do initial and follow up calls to insurance companies regarding any issues with client account that may delay payment of services.
• Review and work claims in the clearing house. This may include but not limited to rejections, pending approval, transmitted, or deleted.
• Prepare checks and reconcile checks with clients' accounts with cover sheet and send to bookkeeping for processing.
• Attends meetings when deem necessary by billing department.
• Perform other tasks assigned (on an as needed basis) by the supervisor.

Qualifications:

• Prior Medical Billing of 3 years and more.
• Knowledge of Medicaid, Medicaid Manage Care, Child HealthPlus, Commercial Insurance and other benefit programs such as HRA.
• Strong problem solving skills.
• Strong effective communication skills.
• Adept in Microsoft Office, Outlook, and Excel.
• Ability to work in a busy and fast paced environment individuals as well as a team player.

Work Environment:

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Must have ability to travel among assigned sites as needed. There may be long periods of standing, sitting, and computer usage.

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