This job was posted by https://www.azjobconnection.gov : For more information, please see: https://www.azjobconnection.gov/jobs/6520169

Summary

The Billing Specialist is responsible for verifying that insurance claims are properly submitted, and all services provided to clients are billed out to the correct payers promptly, following up on unpaid reimbursements. This process involves reviewing client records, maintaining data in clinical databases, and using EHR software to correctly assign procedural and diagnostic codes.

Essential Duties and Responsibilities:

Submit claims for services for new or existing clients services provided for new or existing clients by insurance and payor policies while following all federal, state, and local regulations including Medicare and Medicaid guidelines.

Provide mediation between WGA and clients and responsible personnel and sources of revenue, to ensure he appropriateness and accuracy of all changes as well as records of all client transactions.

Maintain all client accounts with the use of a billing system using codes meant to facilitate reimbursement from commercial and government insurance groups.

Collect necessary client data on diagnosis, treatment, eligibility, and insurance verification required for billing purposes.

Manage the status of client accounts and balances and identity inconsistencies; ability to review, update/correct erroneous billed changes or claims.

Resolve reimbursement problems with insurance companies (overpayments, duplicate payments, non-coordinated secondary payments, coding errors.)

Reconcile and rack incoming electronic payments and remittances receive, sort, and accurately apply all incoming payments with attention to credibility.

Monitor and work aged receivables reports, checking the status of claims and appeals.

Work collaboratively with the administration team to collect prepare and record daily bank deposits.

Handle incoming business office phone calls; respond to billing questions from clients. Administration/clinical teams and payors/insurance companies. Prepare letters and correspondence for accounts collection using appropriate spelling, punctuation, and grammar.

Attend and participate in staff meetings and trainings. Adhere to/maintain client confidentiality according to HIPAA and Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2) Knowledge of and compliance with WGA policies and procedures and other duties as required or assigned.