What are the responsibilities and job description for the Billing Specialist position at Autism Systems?
Pay will commensurate with experience.
Are you looking for an environment that supports your professional development? Want a place where your voice matters? Want to work for a statewide company comprised of small, local, connected teams?
Join our team at Autism Systems. We’re looking for a Billing Specialist to join our team in Macomb County, MI!
The Billing & Credentialing Specialist is responsible for provider enrollment, follow up with health plans until an effective date is obtained, maintaining excel spreadsheets on status and monitoring all CAQH data to be updated. This position also coordinates with clients on claims resolution due to enrollment issues. In addition, you will be responsible for reviewing medical records and insurance claims to determine the procedure code or diagnosis that best matches the medical service. You will determine if payment has been received from the patient and send notification to the insurance company. You will handle claims administration and reimbursements, making sure all claims are processed in a timely manner. This job requires excellent attention to detail, excellent computer skills and knowledge of medical terminology is essential.
ABOUT AUTISM SYSTEMS
Autism Systems is an Applied Behavioral Analysis (ABA) treatment provider committed to providing the best quality care for our clients. We take aim to continually establish best-in-class standards in integrity and quality for not only ourselves and clients, but also in the field of ABA. We collaborate with client families, focusing on the individuality of each child, to generate longevity in client outcomes. We strive to hire and to invest in our greatest asset - our employees, who are the heart of Autism Systems.
You’ll have the opportunity to work in a team-oriented environment and engage in a wide range of activities, focused on providing Applied Behavior Analysis in our clinical centers and in client homes.
What our Billing Specialist do:
- Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
- Obtain referrals and pre-authorizations as required for diagnostic reports, treatments, and therapy.
- Review client bills for accuracy and completeness and obtain any missing information.
- Follow up on unpaid claims within standard billing cycle timeframe.
- Check each insurance payment for accuracy and compliance
- Call insurance companies regarding any discrepancy in payments if necessary
- Identify and bill secondary or tertiary insurances.
- Research and appeal denied claims.
- Answering client or insurance telephone inquiries pertaining to assigned accounts.
- Setting up client payment plans and work collection accounts.
- Ensure that centers are in compliance with relevant regulations.
- Prepare, submit and follow-up on all initial payer applications in an accurate and timely manner.
- Review provider credentialing files and obtain any and all missing information.
- Contact and respond to any requests for verification of credentials.
- Ensure credentialing and licensing processes are completed and notifications sent out as needed.
- Maintain and update provider files and rosters
- Develop knowledge of insurance carriers and requirements.
- Establish and maintain relationships with insurance providers and credential personnel.
Requirements:
- At least 2 years experience in ABA Medicaid billing and Tebra
- Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
- Competent use of computer systems and software.
- Familiarity with CPT and ICD-10 Coding.
- Effective communication abilities for phone contacts with insurance payers to resolve issues.
- Customer service skills for interacting with clients regarding medical claims and payments, including communicating with clients and family members of diverse ages and backgrounds.
- Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
- A calm manner and patience working with either clients or insurers during this process.
- Knowledge of accounting and bookkeeping procedures.
- Knowledge of medical terminology likely to be encountered in medical claims.
- Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
You're perfect for the position if you:
- Minimum 2 years billing experience in a healthcare setting required
- Must have excellent computer knowledge of Patient Accounting systems
- Associates degree or equivalent; Bachelor’s degree in related field desired
- data entry accuracy
- tech savviness
Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience and may fall outside of the range shown.
Billing Specialist
Job Types: Part-time
Starting at $20hr!!
Why work for Autism Systems:
- Paid time off
- Flexible Schedule
- Professional development funds
- Positive and collaborative environment
- Supportive administrative back office
Collaborating with and accredited by the BHCOE, is an international accrediting body created to meet accreditation needs specific to the delivery of behavior analysis.
BHCOE Accreditation® is an earned certification and a distinction among ABA providers that demonstrates an organization’s commitment to quality and continuous improvement in applied behavior analysis. Behavioral Health Center of Excellence® (BHCOE®) grants accreditations to organizations who meet the standards for clinical and operational quality.
Our Locations: SAGINAW 6200 State St. Ste.3 Saginaw, Michigan 48603: BRIDGEPORT 6296 #2 Bridgeport Village Sq Dr Bridgeport, Michigan 48722: FORT GRATIOT Blue Water Business Center 3245 Keewahdin Road Fort Gratiot, Michigan 48059; OSCODA 209 S. State Street Oscoda, Michigan 48750; MACOMB 28241 Mound Rd. Warren, MI 48092; MARYSVILLE 195 Huron Ave. Marysville, Michigan 48040;
APPLY NOW
Job Type: Full-time
Pay: From $20.00 per hour
Benefits:
- Flexible schedule
- Paid time off
Schedule:
- Day shift
- Monday to Friday
Ability to Relocate:
- Warren, MI 48092: Relocate before starting work (Required)
Work Location: In person
Salary : $20
