Billing Specialist

Maintains the enrollment activities and coordinates, reviews, and processes billing-related activities for Balance Autism’s Speech and Occupational Therapy programs. The Billing Specialist uses set guidelines, best practices, and works towards the objectives established by the Operations Director.

ESSENTIAL DUTIES:

· Assist in the admission process for Balance Autism families interested in SLP, OT services.

· Establish and maintain billing systems for all funding related to speech and occupational therapy which may include commercial insurance, Medicaid funding and private pay funding.

· Collaborate with service teams to ensure service authorizations are received and correctly maintained in the billing software program for persons served.

· Constantly contributes to improving processes and resolving issues related to service billing by facilitating billing processes with standardized practices and assisting with accounting and customer service.

· Reviews and follows up on all processes regarding billing and past due account balances to maximize collection and detect any remaining errors in the accounts receivable aging schedules.

· Verify charges, procedure codes, and diagnosis codes utilizing appropriate modifiers and diagnosis digits.

· Prepare and submit monthly or weekly claims to the correct payers within a specified timeline for primary and secondary payers. May prepare monthly invoices for families and other pay sources. May make recommendations for adjustments and write-offs of non-collectible accounts.

· Perform various collection actions, including contacting patients and third-party payers.

· Review and assist in appealing unpaid claims and help resolve payment discrepancies. Works aged accounts to ensure reimbursement.

· Participate in the design and implementation of new accounting procedures and processes for new and existing programs.

· May assist to establish and maintain systems that allow Balance Autism to access insurance funding, including credentialing the agency and applicable Speech Language Therapists and Occupational Therapists.

· Review account receivables monthly and adjudicate past due claims for all funding sources to align with billing documentation exceeding 60 days old.

· Contact members monthly to obtain payments or relay account information.

· Collaborate with service teams to ensure monthly billing is completed by deadlines.

· Participate in the development and reporting of metrics data as assigned.

· Other duties as assigned.

REQUIREMENTS

· Coding certification and/or associate’s degree in related field, or equivalent combination of education and experience.

· Knowledge of various computer software, insurance billing software, and financial software.

· Knowledge of disability services.

· Outstanding written and oral communication skills.

· Understanding of medical terminology and coding preferred.

· Preferred: Bachelor's degree with related experience in the medical field with at least one year of experience.

PHYSICAL/ WORK REQUIREMENTS:

· Must be able to sit, talk, and hear.

· Frequently required to use hands to finger, handle, or feel.

· Occasionally required to stand and walk.

· Occasionally lift and/or move up to 10 lbs.

· Specific vision abilities required by this job include close vision and ability to adjust focus.

· The noise level in the work environment is usually moderate.

Balance Autism is an equal opportunity employer.