What are the responsibilities and job description for the Medical Billing Specialist position at Avenir Behavioral Health Center?
DEPARTMENT - Administration
REPORTS TO - Executive Director
FLSA STATUS - Non-Exempt
WORK SCHEDULE - Variable hours (may include some weekend and holiday hours)
POSITION SUMMARY
Manages all Business Office and Accounting processes at the facility and acts as the liaison between the facility and corporate financial operations :
Business Office (admissions, discharges, insurance / payor verification, financial counseling, charge entry, billing, collections, denials)
Accounting (purchasing, invoicing, various logs)
Responsible for the accuracy of the accounts receivable patient set-up.
Facilitates patient evaluation and admission by providing a variety of administrative and clerical tasks.
Interacts daily with Intake, Utilization Review, Nursing, Social Services, Medical Records Departments as well as the Centralized Business Office (CBO), and facility CEO.
ESSENTIAL JOB FUNCTIONS
Possesses the authority to exercise independent judgment and discretion in matters of significance related to patient financial accounting.
Gather patient demographic information along with primary and secondary insurance coverage information through interviews with patient, family, external agencies, referring hospitals, etc.
Photocopy all insurance cards.
Verify insurance benefits.
Coordinate and communicate verified insurance information to facility staff in a legible, timely and complete manner.
Communicate denial or other pertinent account information to ED.
Initiate completion of other required paperwork as appropriate.
Ensure admission authorization is obtained and documented per facility protocols. Perform notifications as required for patient reimbursement.
Accurately enter patient information into patient accounting system.
Use math skills to accurately calculate patient financial liability using information obtained from the verification process and insurance card(s).
Collect patient deductibles and co-insurance prior to discharge.
Process purchase requests using established procedures and vendors.
Create and / or maintain other logs / spreadsheets as required by Corporate Accounting or the Centralized Business Office
Interact and communicate professionally and appropriately.
Present a professional and business-appropriate appearance.
Use available technology : copier, scanner, fax, email, internet, etc. appropriately and efficiently.
Demonstrate extensive problem-solving capabilities.
Organize work in order to meet deadlines.
Adapt to change in direction to meet shifting and competing priorities.
Work as a member of both the facility team and CBO team.
Acknowledge and respond to concerns, requests and needs in a timely manner.
Interact with patients, families, vendors, staff, and all others in a respectful and professional manner.
Act within scope of authority and reports and unresolved issues quickly and appropriately.
Educate patient / family on community resources as applicable.
QUALIFICATIONS
EDUCATION - Bachelor's Degree or equivalent work experience
EXPERIENCE - Minimum of three to five years of business office and medical billing experience, preferably in a healthcare behavioral health setting. Excellent math, Microsoft Excel, customer service, and communication skills. Working knowledge of Medicare / Medicaid and insurance verification process.
