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Billing Specialist I

Orchard Park

Summary of Position Function

Responsible for organizing, coordinating and monitoring billing related functions as assigned by and under the direction of the Director of Information Management; coordinating communications between the team members and internal and external vendors; maintaining accounting and financial records for client and payer related activity and operating the management information system.

Education Requirements

High School Diploma or equivalent

Experience

One work-related experience

Must possess a valid Driver’s License with an acceptable driving record

Interested in this position?

Major Duties & Responsibilities

  • Performs authorization verification functions’ obtains required information and addresses problems
  • Works with site office staff to ensure that all insurance information, procedures and rules are current and adhered to
  • Enters all financial related information into Anasazi within a 48 hour period and verifies accuracy
  • Verification of diagnosis and assures demographic information is accurate
  • Assures appropriate staff are assigned based on insurance rules, notifies Directors of potential case transfers
  • Verifies and enters Insurance and private fee data including authorizations if required
  • Verifies on multiple treatment episodes that Assessment Services do not exceed regulatory requirements.   Notifies EMR department accordingly
  • Tracks and verifies new clients financial data is received at Administration within 48 hours of assessment visit
  • Works with site secretaries to correct information deficiencies and address problems
  • Monitors all fee for service billing to ensure regulatory compliance and adherence to agency submission timeframes
  • Processes Medicaid and 3rd Party Payer claims on a bi-weekly basis generating claim batches. Basic level and low volume of claims.
  • Reviewing for any SED code changes, 0fill coding and 3rd Party adjustment codes
  • Submits 837 files and verifies 277 acceptance file
  • Processes follow-up on all pended and denied claims Basic level and low volume of claims.
  • Processes all private fee monthly statements, no later than 1 workday after Fiscal Closing, work schedule must accommodate this process.
  • Is responsible that all coding, pricing and authorizations updates are accurately reported to the Accounts Receivable Director for programming into the Anasazi software
  • Adheres to Code of Ethics; reports all concerns and violations to management staff and/or Compliance Officer
  • Operates office machines and instructs others in the operation of same

SKILLS/COMPETENCIES:

  • Excellent interpersonal skills and communication skills both verbal and written
  • Requires organizational skill and ability to make contacts and establish relationships to obtain information necessary for the program to functions within the larger system
  • Meticulous documentation/recording skills and attention to detail; excellent time management and organizational skills
  • Ability to handle multiple tasks
  • Proficient in the use of computer software such as MSWord, Excel, Power Point, Desktop Publishing, Outlook, etc.
  • Ability to operate office equipment

Interested in this position?

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