Billing/AR Specialist

This position is accountable for all steps in the billing process including processing medical claim information through data-entry in the EMR, and researching and correcting data entry errors using eClinicalWorks. This position uses knowledge of CPT and ICD-10 codes to accurately depict medical claim information. This position is in a primary care and behavioral health social service setting with specialized LGBTQ+ care and services.

Primary Tasks/Responsibilities:

• Review claims data to ensure that assigned codes meet required legal and insurance rules, and that required signatures and authorizations are in place prior to submission
• Submitting claims for services rendered to insurance companies
• Posting payments based on remittance advice, cash/credit/check payments as needed.
• Working directly with the insurance company, the patient, and clinic staff to get claims appropriately processed and paid timely.
• Working Billing Queues including but not limited to AR follow-up, clearinghouse rejections, denials, insurance aging, pending with errors and patient self-pay accounts.
• Reviewing and appealing denied and unpaid claims.
• Monitoring and updating patient AR balances.
• Tracking and updating the Aging Report and working patient accounts for accuracy.
• Answering questions patients or payers may have about billing.
• Reviewing patient bills for accuracy and completeness and obtain any missing information.
• Handling collections and unpaid accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients when there is a lapse in payment.

Education/Professional:

• Minimum of 2 years of experience as a medical billing specialist in primary care and behavioral health setting highly preferred.
• Experience working with multiple third party payers including Medicaid, Medicare, Managed Care, HMO/PPOs.

Knowledge, Skills and Competencies Required:

• Strong knowledge of and able to easily navigate Medicaid, Medicare, HMOs, and private payer systems
• Knowledge of EMR systems, preferably with eClinicalWorks.
• Microsoft suite and data systems proficiency, including Electronic Medical Records.
• Ability to effectively communicate both written and verbally.
• Ability to effectively utilize problem-solving and decision-making techniques.
• Ability to make effective judgments and decisions based on objective criteria.
• Attentive to detail and strong organizational skills.
• Ability to tactfully interact with diverse personalities.
• High comfort working in a busy environment with changing priorities.

Requirements:

• Must possess and maintain valid Florida driver’s license and proof of insurance
• Must have reliable and accessible auto vehicle.
• Must pass necessary fingerprinting, Level II background checks and employment eligibility verification through the U. S. Department of Homeland Security’s E-Verify system, https://e-verify.uscis.gov/emp.