Description

***Effective October 15, 2021, all employees/contractors/interns/volunteers are required to provide our office with proof of COVID vaccination.***

Billing and Registration Specialist Shift: 

Monday-Friday 8:30AM-4:30PM

Openings:

One (1) Opening

Billing and Registration Specialist Salary: 

Billing and Registration Specialist Position Summary 

The primary responsibility of the Billing and Registration Specialist is to be able to proactively monitor the billing and claims resolution of the Outpatient programs and provide support to the Central Registration Department Call Center. 

Billing and Registration Specialist Duties and Responsibilities 

Billing Review and Management 

• The Billing and Registration Specialist will review all billing and utilization within Outpatient services, ensuring accurate billing that complies with all internal and external requirements and guidelines. 
• Work through any discrepancies immediately upon review; making corrections where necessary. 
• Confirm that all services provided have been provided and accurately documented per billing procedures and guidelines. 
• Communicate any processing issues to the Outpatient Division Director and/or additional support team member as directed. 
• Communicate with Service Coordination Organizations, program staff and other stakeholders to settle utilization and billing issues and resolve patient accounts effectively. 
• Confirm that all services provided have been accurately captured. 
• Review all program admissions, discharges, and transfers for accuracy. 
• Review placement disruptions for accuracy and timeliness and partner with team members to resolve issues. 
• Appropriately process and submit all services to be billed in a timely manner. 
• Appeal all claims that were unable to be billed within the funders’ required timeframe. 
• Facilitate regular billing meetings with program supervisors and other required staff. 
• Track and follow up on billing/authorization issues and provide information to resolve outstanding balances. 

Central Registration 

• Effectively respond to a high volume of incoming calls in the Behavioral Health Outpatient Central Registration Department call center. 
• The document required information from the caller by following the program questionnaire to accurately determine the caller’s needs and eligibility of services. 
• Entry of all data into agency database to create the initial Electronic Health Record. 
• Ensure consumer(s) are being provided with the appropriate information during calls to ensure they’re informed of the accurate location, date, and appointment time. 
• Maintain and update existing information within the database which includes but is not limited to scanning and saving documents in the Electronic Health Record. 
• Maintain communication with internal departments. 

Other duties reasonable and related to this position as directed by related supervisors. 

Billing and Registration Specialist Skill Requirements 

• Excellent mathematical skills 
• Excellent verbal and written communication skills. 
• Excellent interpersonal and customer service skills. 
• Proficient in Microsoft Office Suite or related software. 
• Excellent organizational skills and attention to detail. 
• Must be self-motivated and willing to learn multiple tasks. 
• Must be well-organized and able to prioritize tasks. 
• Must have commitment to excellence in customer service. 
• Basic understanding of clerical procedures and systems such as recordkeeping and filing. 
• Ability to work independently. 
• Ability to read and write in English and Spanish. 
• Ability to apply common sense and understanding to carry out instructions furnished in written, oral, or diagram dorm. 
• Ability to deal with problems involving several concreate variables in standardized situations. 
• Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas as well as interact professionally and effectively with members, clients, and staff from all departments within and outside the company. 
• Problem solving skills with the ability to look for root causes and implementable, workable solutions. 

Requirements

Education, Employment and Credential Requirements 

• High School Diploma or GED and five (5) years’ experience in a high-volume Medical Insurance Billing/EHR setting. 
• College degree in any related field.
• Must be proficient in Microsoft Office Programs. 
• One (1) to three (3) years of experience in customer service in a healthcare environment.
• PA Medicaid, Medicare insurance/payor experience preferred. 
• Knowledge of PROMISE systems, Connect, NaviNet Novitasphere, as well as EHR experience preferred. 
• Experience with Netsmart “Evolv” Suite application is preferred. 
• Bilingual, English/Spanish preferred. 
• Valid PA State Criminal, FBI, Child Abuse clearances. 
• Clearances must be updated every 3 years per COMHAR policy. 
• Must have a current ACT 31 (Recognizing and Reporting Child Abuse Certificate).
• Adult and Child CPR w/AED & First Aid certification required.