Billing Specialist

Developmental Pathways is seeking an experienced Medical Biller with experience in ABA services to work in our administrative office. The ideal candidate will have a strong background in medical billing, with the skills necessary to improve our current billing procedures and reduce A/R days. The successful applicant will work on a number of tasks requiring data analysis, in-depth evaluation and exercising judgement within the appropriate scope of practice. We offer excellent benefits, generous paid time off and competitive compensation.

Responsibilities:

· Audits and corrects all claims on UB04 and/or CMS 1500 format.

· Review all EOB’s received in the mail that require attention.

· Complete data entry of all patient demographics, guarantor, and insurance information.

· Post procedures and insurance.

· Manage relationships with various Insurance payers.

· Call insurance companies to resolve billing issues.

· Call for Verification of Benefits.

· File claims to ensure maximum entitled reimbursement.

· Follow orders of detailed work activity.

· Ensure all claims are submitted with a goal of zero errors.

· Verify completeness and accuracy of all claims prior to submission.

· Meet all deadlines given.

· Read and interpret insurance explanation of benefits.

· Respond to inquiries from insurance companies, patients, and providers.

· Regularly meet with Financial Manager to discuss and resolve reimbursement issues or billing obstacles.

· Attend monthly staff meetings and continuing educational sessions as requested.

· Perform additional duties as requested by Director or Management team.

· Obtaining referrals and pre-authorizations as required for procedures.

· Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.

· Following up on unpaid claims within standard billing cycle timeframe.

· Checking each insurance payment for accuracy and compliance with contract discount.

· Calling insurance companies regarding any discrepancy in payments if necessary

· Identifying and billing secondary or tertiary insurances.

· Researching and appealing denied claims.

· Setting up patient payment plans and work collection accounts.

· Updating billing software with rate changes.

· Updating cash spreadsheets and running collection reports.

Qualifications:

· High School Diploma/GED required.

· Minimum 2 years’ experience as a Medical Biller.

· Experience in ABA service codes required.

· Experience with NPA codemetro and Office Ally.

· Proficiency with electronic medical records (EMR)

· Strong knowledge of MS Access

· Ability to work independently and collaboratively within a team environment

· Able to multi-task and meet tight deadlines

· Excellent problem-solving skills

License:

· Driver's License (Required)

Typical start time:

· 9AM

Typical end time:

· 6PM

Pay Frequency:

· Bi weekly or Twice monthly

Pay:

· Hourly: $18 to $23 (upon knowledge and experience)

Schedule:

· Monday to Friday

· Day shift

Company's website:

· www.dpica.com

Work Remotely:

· No