Insurance Billing Specialist

Position Summary:

The Insurance Billing Specialist offers accurate data submission, to relay accurate and timely information to management, staff, and other identified end users. This position will work both independently and part of a team to monitor and complete expected data analysis and quality assurance assignments. This position is expected to complete work in a timely, professional manner consistent with data submission standards.

Responsibilities:

Review explanation of benefits from the insurance carriers to post appropriate payments and denial codes.

• Identify remittances with a secondary payer and takes appropriate action to send to secondary carriers.
• Analyze balance reports to ensure accurate postings.
• Input zero payment vouchers and insurance denials from all payer sources in a timely manner.
• Assist staff with payment and adjustment questions and research as needed.
• Post manual payments not posted electronically; post allowances, adjustments, and write-offs/write-ups.
• Process refunds and recoups within the EHR system.

Complete Applied Behavioral Analysis (ABA) billing.

• Obtain authorization for all payers that require a prior authorization and communicate with the ABA staff for authorization extensions.
• Email ABA staff regarding failed activities.
• Prepare, review, and submit clean claims to insurance companies/clearing house electronically.
• Identify and resolve client billing complaints.
• Maintain working knowledge of regulations for Federal, State, and third-party payers, including, but not limited to: Medicaid, Tribal billing, and commercial insurance.
• Assist insurance companies with billing and reimbursement issues; follow up with payment, denials, and appeals.

Maintain confidentiality of all business practices and adhere to all HIPAA guidelines/regulations.

• Participate in Managed Care meetings for data updates as needed.
• Respond to emails in a timely and professional manner.
• Maintain current knowledge of CPT codes and descriptions.
• Stay informed with current insurance billing requirements and changes.
• Assist with special projects, and other duties as assigned.

Perform other duties as assigned.

Job Requirements:

The following requirements are those that are normally required for performance of this position. Any disabled applicant or incumbent who does not meet one or more of the requirements, but who can perform the essential function of the job (with or without reasonable accommodations) shall be deemed to meet these requirements.

Physical Requirements:

This position normally requires the physical demands of standing, walking, bending, lifting or performing other work requiring low physical exertion, talking and hearing and adequate vision on a regular basis to perform job requirements. These physical demands are required up to 90% of the time.

Non-Physical Requirements:

Education

• High School Diploma -Required
• College Degree or Certificate of Completion (Computer Science, Behavioral Analytics, Finance, Accounting) - Preferred

Experience

• 2 years' experience with EHR Systems (CareLogic QualiFacts experience, preferred)
• Knowledge of State data requirements related to community Mental Health
• 3 years billing experience, required (Physician Billing, preferred)

Special Skills

• Pleasant, welcoming, and friendly demeanor with staff and clients.
• Able to work independently or as part of a team.
• Knowledge of office practices and procedures.
• Detail oriented and able to multi-task.
• Computer word processing using Microsoft Office and Google Docs.
• Experienced with the use of standard office equipmentincluding computers, copiers, fax, phone, calculator, TTY, and/or other equipmentfound in work unit.
• Maintain positive, team-oriented service attitude toward clients and staff.
• The ability to work independently with strong, problem-solving skills.

Employment is conditional upon:

• Being cleared by criminal background check and fingerprinting when required

Work Schedule:Monday-Friday 8am-5pm

Wage Range:$23.00-$27.50 per hour depending on experience

Benefits:

• 13 paid holidays, 12 days of vacation, 12 days of sick leave per year
• Health insurance including medical & prescription coverage, with optional dental and vision insurance plans. Majority of premiums paid by Catholic Charities
• Retirement 403(b) Plan: employee contributions commence upon employment; Catholic Charities contributes 2% of monthly income and matches up to 4% of employee contributions following 6 months of employment
• Basic Life Insurance paid 100% by Catholic Charities
• Flexible Spending Account eligibility following 6 months of employment
• Education Assistance Program reimbursing up to $5,250 per year for approved continuing education after 6 months of employment
• Additional voluntary insurances including supplemental life, accidental death & dismemberment (AD&D), critical illness, long term disability, accident, and ID theft
• Employee Assistance Program includes 3 counseling sessions per year, legal consultations, financial coaching, and other wellbeing tools
• Annual longevity awards begin at 5 years of employment

It is the practice of Catholic Charities to ensure equal employment opportunity without discrimination or harassment on the basis of race, color, national origin, sex, age, disability, citizenship status, marital status, creed, genetic predisposition or carrier status, sexual orientation, gender expression, or any other characteristic protected by applicable law. Applicants from underrepresented backgrounds are encouraged to apply. We gladly offer reasonable accommodations to individuals with disabilities to support participation in the hiring process and employment.