Billing Specialist - Preventive Measures : Job Details

The billing specialist performs a variety of duties involved in the billing and collections for Behavioral/ Mental Health Services. Their list of responsibilities includes insurance verification, managing billing for clients, updating client information, generating invoices, and processing payments with emphasis on Medicaid, Medicare and Commercial insurances. They will also be responsible for coordinating payment schedules for self-pay customers, following up on insurance claims, posting payments in a timely manner, helping resolve client billing issues, and other duties as assigned.Interrelationship: Must be able to communicate with various Preventive Measures staff and clients to navigate needs effectively.Primary Job Responsibilities: Verify insurance information for new patients and referrals. Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Prepares bills/data for all pay sources, fulfilling individual requirements for each pay source to bill accurately. Adjusts any billing/data errors found on bill in a timely manner. Update insurance information for existing patients Call to obtain pre-authorization for recommended services and procedures. Explain to patients what their financial responsibilities will be. Inform relevant clinical staff about denials. Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper UB04/HCFA 1500 forms for Medicare, Medicaid, Commercial Insurance and Private Pay. Identify and correct inconsistencies. Manage Billing software systems. Reconcile A/R and posting of payments. Communicate billing and authorization concerns with Insurance Companies and Supports Coordinators Prepare billing reconciliation reports and provide root cause analysis. Professionally interact and engage multiple operational groups across the company and outside clients. Represent the company in a professional and positive manner in all facets. Other duties and responsibilities as assigned.Job Skills: Demonstrated proficiency in Microsoft Demonstrated proficiency in Medical EHR software. Demonstrated ability to prioritize tasks and meet fixed deadlines. Demonstrated ability to effectively communicate in writing and verbally with patients, responsible parties, staff, and pay source representatives Demonstrated ability to establish and maintain effective working relationships with team members, patients, other agencies, and partners. Credible knowledge is a plus.Education/Experience: Minimum two years of Mental Health billing experience required with an emphasis on Medicaid, Medicare, and Commercial payers Medical terminology, ICD-10, and CPT Knowledge of general medical recordkeeping proceduresJoin our Team!Company website: Preventive Measures is committed to equal opportunity for all employees and applicants. As a proud Equal Opportunity Employer (EOE), we do not discriminate based on race, color, national origin, ancestry, citizenship status, religion, sex, sexual stereotyping, sexual orientation, gender, gender identity, gender expression, age, marital status, mental or physical disability, medical condition, genetic information, military or veteran status, pregnancy (which includes pregnancy, childbirth, and medical conditions related to pregnancy, childbirth, or breastfeeding), or any other protected characteristic. Employment may be contingent upon receipt of and passing all job-related clearances, background checks and regulated requirements as applicable and permissible by law.