What are the responsibilities and job description for the MEDICAID BILLING SPECIALIST position at Coastal Horizons Center?

Job Description

COASTAL HORIZONS CENTER, INC.

JOB TITLE : MEDICAID BILLING SPECIALIST

SUPERVISED BY : AR MANAGER

REQUIRED EDUCATIONAL / EXPERIENTIAL QUALIFICATIONS

High school diploma or GED with 2-3 years' experience related to responsibilities specified. Familiar with billing concepts, practices, and procedures.
Knowledge of health care billing systems, procedures, documentation, and standards.
Familiar with DSM and ICD-10 codes
Previous experience with billing commercial payers
Knowledge of billing / insurance terminology
Basic computer skills including Excel
Strong organizational, problem solving and analytical skills.
Working knowledge of cash management principles and / or procedures.

GENERAL STATEMENT OF DUTIES :

The Medicaid Billing Specialist is responsible for providing financial, administrative and clerical services to ensure accuracy and efficiency of Coastal Horizons Center's billing operations as it relates to the accounts receivable. This position will be responsible for following up on commercial claim denials and will work directly with our payers and providers to rectify denials so that they can be accurately adjudicated for payment.

ESSENTIAL DUTIES AND TASKS :

Assist with processing payments in compliance with financial policies and procedures

Perform day to day financial transactions including verifying, classifying, computing, posting and recording accounts receivable data

Verify billing accounts with accounts receivable ledger to ensure that all payments are accounted for and properly posted

Thoroughly review clinical documentation and communicate directly with the clinical staff when errors need to be corrected in order to receive payment.

Reprocess claims within EMR and / or directly on the payer’s website to assure timely receipt of payment

Work directly with commercial / private payers

Reconcile claims weekly to ensure receipt of claim by the payer.

Encourages teamwork, energetic and motivates teams and individuals.

Maintains a cooperative work environment to foster Coastal Horizons Center's missions and values and to meet goals.

Proficient with MS Office (word, excel, power point, access); excellent with spreadsheet and medical billing software applications.

Performs miscellaneous job-related duties as assigned.

Must be able to perform sedentary work exerting up to ten (10) pounds of force occasionally and / or a negligible amount of force frequently on constantly to lift, carry, push, pull, or otherwise move objects.

Must possess the visual acuity to prepare and analyze data and figures and operate a computer terminal.

SALARY : Commensurate with education and experience. Benefits available include health / medical, dental, life insurance, paid time off programs, 401 K retirement savings plan. For more information, please visit our website at www.coastalhorizons.org

Coastal Horizons is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, disability, or veteran status.

An Equal Opportunity / Affirmative Action Employer; Complying with The Immigration Reform and Control Act.

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MEDICAID BILLING SPECIALIST

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