Job description
Billing Specialist
ABC Behavior Therapy, LLC (ABC) is a child and family-centered ABA agency seeking a Billing and Coding Specialist (BCS) to assist with entering, uploading and coding patient services. The Specialist will be responsible for generating invoices to be sent to the patient. They will also sort and file paperwork, handle insurance claims, and perform collections duties. Within the scope of these duties, the BCS will also assist with coordination of patient services as needed. This position serves to ensure compliance with requirements of funding sources which thereby protects patients against unforeseen interruptions in services.
Duties and Responsibilities:
Job Qualifications: Required:
ABC Behavior Therapy, LLC (ABC) is a child and family-centered ABA agency seeking a Billing and Coding Specialist (BCS) to assist with entering, uploading and coding patient services. The Specialist will be responsible for generating invoices to be sent to the patient. They will also sort and file paperwork, handle insurance claims, and perform collections duties. Within the scope of these duties, the BCS will also assist with coordination of patient services as needed. This position serves to ensure compliance with requirements of funding sources which thereby protects patients against unforeseen interruptions in services.
Duties and Responsibilities:
- Translate patient information into alphanumeric medical code for reporting purposes if applicable
- Submit claims and process payments
- Verify eligibility, benefits, and patient responsibility for new clients and current clients on a semi annual basis. Review & edit ICD 10 diagnosis codes in patient charts as needed
- Code patient services and enter into the data collection system
- Enter Calendar sessions on accupoint
- Conduct bi-weekly audits to ensure claims processed
- Create folder to show timely filings for each insurance
- Appeal Process if needed
- Design and maintain spreadsheets for collection purposes.
- Transform billing data into charts, graphs or other useful data for Administrative review
- Monitor Patient Accounts- Follow up on accepted/denied claims & investigate rejected claims
- Patient Care Coordination
- Collect, post, and manage patient account payments to include sending patient invoices to families
- Prepare and review patient statements and EOBs
- Review delinquent accounts and contact families for collection purposes and/or payment plans
- Complete Fee Agreement contracts for families (initial, bi-annual, and annual)
- Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding
- Reach out to referring doctor’s office as needed to confirm diagnosis and updated referrals yearly
- Create NPI Numbers for new staff
- Ensure that authorizations for patients are updated
- Submit new authorization requests for new and continuing clients
- Create folders to track what is needed for each insurance company
- Reconcile employee benefits to ensure accuracy and make proper payments (medical, dental and AFLAC)
- Update ADP with employee deductions for training, medical and dental deductions
- Accupoint/Catalyst
- Pull notes from Catalyst to enter into Accupoint weekly
- Input New employees into Accupoint- enter NPI
- Create base schedule for clients into accupoint so notes sync
- Complete Quarterly Audits/ Develop system
Job Qualifications: Required:
- High school diploma or equivalent
- Minimum of 2 years of billing experience
- Proficiency with computers and medical billing software
- Knowledge of unfair debt collection practices and insurance guidelines
- Understanding of primary code classifications: ICD-10-CM, ICD-10-PCS, CPT and HCPCS
- Understanding DSM -5 and/or ICD-10 Diagnostic Codes
- Understanding of Timely filing Requirements per insurance company
- Communication skills with patients/healthcare companies
- Strong written and verbal skills
- Great Time Management Skills; Multitasker
- Thorough knowledge of health care benefits and insurance regulations.
- A Bachelor's degree in healthcare administration or health information management
- Successful completion of the CPC Certification Exam
- Basic accounting and bookkeeping practices
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