What are the responsibilities and job description for the Direct Billing Specialist position at Aegis Therapies?
Position: Direct Billing Specialist
- Hours: Full Time
- Setting: Corporate office
- Location: Hybrid to Fort Smith, AR
GENERAL PURPOSE
Performs all duties related to the timely and efficient billing and collection of private and other payer receivables for a group of clinics in a central billing environment, within the parameters established by company policies and third-party billing requirements, and as necessary to achieve reasonable collection goals.
ESSENTIAL JOB DUTIES
- Prepares and submits all claims/statements for Private, Medicaid, Medicare, etc. including primary, secondary and supplemental, as required.
- Utilizes tracker spreadsheet to document and follow up on payer commitments.
- Responds to payer requests for documentation.
- Identifies payment discrepancies and unpaid claims; takes appropriate action to resolve balance.
- Prepares A/R adjustments and corrections as needed.
- Identifies, researches and resolves credit balances according to policy and payer requirements.
- Responds to all requests for information, documentation and account corrections, where applicable.
- Identifies adverse trends resulting in returned or denied claims (e.g., repeated failure to obtain prior authorization) and communicates to CBO Manager.
- Reports status of claims and AR balances to supervisor, upon demand and/or according to established schedule and procedures.
- Participates in monthly AR review.
- Prepares account write-off when collection efforts exhaust.
QUALIFICATIONS
- High school diploma or equivalent
- Minimum of one (1) year experience in health care insurance billing, preferably for therapy billing or a skilled nursing facility provider.
- Must be capable of maintaining regular attendance
KNOWLEDGE, SKILLS, ABILITIES & BEHAVIORS
- Working knowledge of Microsoft Office applications (Outlook, Word, Excel, & PowerPoint) and ability to learn company or customer systems
- Good knowledge of Private (Self-Pay), Medicare, Medicaid, commercial insurance and managed care plans, including basic coverage models, billing requirements, subscriber and provider responsibilities, and coordination of benefit (COB) rules.
- Knowledge of SMART billing system preferred.
- Ability to manage, analyze and reconcile billing and payment detail.
- Ability to work under pressure, meet changing deadlines, and maintain orderly files.
- Ability to work well in a team-oriented, cooperative environment.
- Good written, verbal, telephone communication, and organizational skills.
- Knowledge of how to operate a 10-key calculator.
- Must be able to maintain confidentiality regarding patient, employee and company proprietary information
- Must have the ability to relate professionally and positively and work cooperatively with patients, families, and other employees at all levels
EEO Statement: Aegis Therapies and its Family of Companies is committed to a diverse workforce and is an Equal Opportunity Employer. For detailed information on your rights, Click Here OR https://aegistherapies.com/equal-opportunity-employer-provider-of-healthcare-services/.
