Billing Specialist

Ashland, KY
Full Time
Mid Level

Function:

The Billing Specialist will assist with the maintenance of the Accounts Receivables by providing effective denial management services for all payer types. Posting of client payments to appropriate claims within the Electronic Health Record system (EHR).  Retrieval and posting of insurance payments in accordance with electronic payment notifications received through clearinghouses within the EHR. Review electronic Explanation of Benefits (EOB) statements to ensure accuracy of payment posting.

Organizational duties & responsibilities:

  1. The primary responsibility of all staff is to ensure the safety and well-being of all Ramey-Estep/Re-group (RE) clients.
  2. Supports the mission, vision, and values of RE.  Facilitates and adheres to the agency’s code of ethics, policies, and procedures.
  3. Supports all functions that attain and maintain accreditation and compliance with regulatory agencies.
  4. Supports and facilitates positive interaction with clients and staff by exhibiting both in-office and in-public when carrying out job duties:  individual maturity, respect for others, a team-centered approach, maintenance of confidential information, and awareness and sensitivity to cultural and other differences in clients and staff.
  5. Exhibits effective communication skills, including proper use of agency communication systems.
  6. Participates in appropriate professional development programs to attain and maintain competency.
  7. Effectively manages financial and physical resources to achieve the mission of RE.
  8. Reports incidents of abuse or potential abuse involving clients to the appropriate authorities and RE.

Essential Duties and Responsibilities:

  1. Manages accounts receivable in accordance with RE policy and accounting procedures.
  2. Stay up to date with Medicaid, MCO and Medicare changes by monitoring their websites, newsletters, participating in group calls.  Provide updates to the Finance Director as they are known.
  3. Posting of client payments to appropriate services as they are received.
  4. Retrieve and process electronic EOBs received through clearinghouses.
  5. Review EOB remits to identify denial trends and/or rate issues as they are received.
  6. Posting and review of electronically processed Insurance payments for accuracy.
  7. Manual posting of paper remits received.
  8. Review correspondence from Third Party payers in a timely manner and advise Finance Director of denial trends, audits, and reviews.
  9. Serve as back up for other billing processes.
  10. Performs other duties as assigned.

Working conditions/environment:

  1. Shift is generally dayshift, Monday – Friday in office.
  2. Potential to be remote for non-local candidates.
  3. Holidays, weekends, and extra hours may occasionally be required.
  4. Meals are provided for staff when on campus.
  5. Office setting with extensive computer usage.

minimum job requirements:

Education:

High School Diploma or GED required. 
Associate Degree in Business related or Medical Billing and Coding field preferred, will accept work experience or education in lieu of degree.

Experience:

Two years of Medical Billing and Coding experience with use of EHR is preferred.

Specific Skills and

requirements:

Must be at least 21 years of age.
Must have good organizational skills.
Must be detail oriented.
Must possess excellent customer service skills.
Technical requirements include proficiency with Microsoft Word, Excel, PowerPoint, and any other applications used by the organization or regulatory agencies.
Ability to understand and relate to the needs of clients from diverse backgrounds.
Ability to read, write and converse in English.
Successful completion of a pre-employment drug screen.
Successful completion of a background screening.
Successful completion of a TB skin test or proof of a negative chest x-ray or other documentation.

Specialized Licenses or training:

Successful completion of Excellent Foundations.
Maintain 20 hours of annual training.
Basic EHR Training.

Physical Requirements:

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
While performing the duties of this job, the employee is regularly required to stand, walk, talk, hear, and smell.  The employee frequently is required to sit; use hands to finger, handle, or feel; reach with hands and arms; and stoop, kneel, crouch, and climb stairs.  The employee is occasionally required to climb, balance or run.  The employee must frequently lift and/or move up to 10 pounds or more.  Specific vision abilities required by this job include close vision, distance vision, and peripheral vision. 

Supervisory REquirements:

N/A
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