Billing Specialist
CODA INC
Summary
The Billing Specialist is responsible for all aspects of insurance and patient billing.
Job description
Summary
The Billing Specialist is responsible for all aspects of insurance and patient billing.
Essential Responsibilities and Tasks
- Facilitate timely and accurate pre-bill audit of billing system transactions.
- Prepare and submit error free claims to various insurance companies.
- Contact insurance companies to get authorization for patient services as necessary.
- Identify and resolve patient billing complaints.
- Count cash from PRC, prepare and balance DBR, enter into check log.
- Prepare, review and send patient statements.
- Prepare adjustments and rebills.
- Post and file EOBs as received.
- Respond to patient and colleague questions promptly and efficiently.
- Resolve billing issues by discussing contract with third-party payer; explaining insurance contract with patient; negotiating settlement.
- Maintain patient and invoice files by entering and adjusting data.
- Enter data accurately and efficiently into posting, charge input and authorizations.
- Provide billing information by collecting, analyzing, and summarizing third-party billings, accounts pending, and late charges data and trends.
- Verify that CPT, HCPCS and ICD-10 codes submitted to third-party payers are an accurate representation of the medical services rendered. Research any discrepancies noted prior to charge entry to ensure accuracy.
- Notify the Billing Manager of any regulatory and compliance issues relating to inaccuracies or aberrant billing patterns discovered during the billing process.
Secondary Responsibilities and Tasks
- Provide back up to Customer Service as needed.
Requirements
- Associate Degree in Accounting or Business OR three (3) years of experience in a related field
- Two years' experience in a Medical Office setting
- Experience with ICD-9, ICD-10 and CPT coding issues
- Knowledge of MMIS and CIM (State Medicaid Reporting Systems)
- Knowledge of insurance companies and working AR appeals
- Ability to convey a positive attitude and treat others with respect
- Ability to take personal responsibility for the quality and timeliness of work, and achieve results with little oversight
- Ability to diligently attend to details and pursue quality in accomplishing tasks
- Ability to utilize both oral and written communications skills to effectively communicate with patients, co-workers, community resources, supervisors, and various other individuals encountered in the course of performing work while maintaining patient confidentiality and establishing professional rapport
- Ability to operate a computer, utilize basic MS Office programs, and effectively navigate and maintain patient records in an electronic medical records system
Company overview
CODA INC is a mental health care organization dedicated to providing comprehensive behavioral health services to individuals and communities. The company specializes in delivering evidence-based treatment programs for various mental health conditions, including depression, anxiety, trauma-related disorders, and substance use disorders. CODA INC operates with a patient-centered approach, focusing on holistic care that addresses both psychological and social determinants of mental well-being. Their services typically include individual therapy, group counseling, psychiatric evaluations, medication management, and crisis intervention. As a healthcare provider in the mental health sector, CODA INC plays a crucial role in improving access to quality mental health care and reducing the stigma associated with seeking treatment. The organization likely collaborates with healthcare systems, insurance providers, and community organizations to ensure comprehensive care delivery. Their mission centers on promoting mental wellness, supporting recovery journeys, and enhancing the overall quality of life for individuals facing mental health challenges through compassionate, professional care.