What are the responsibilities and job description for the III Billing Specialist for Substance Use Disorder position at Lummi Nation Tribal Court?
Job Overview
The Substance Use Disorder Billing Specialist III is a pivotal member of our dedicated team, tasked with ensuring the efficient billing processes for both Medicaid and private insurance related to addiction treatment programs. This role is integral to the accurate and timely submission of claims for services rendered, as well as the management of follow-up procedures for Medicaid billing and reimbursement verification. Upholding client confidentiality and information security in accordance with HIPAA regulations is paramount.
Key Responsibilities
We are committed to fostering professional development for our staff, providing exposure to diverse aspects of medical billing, particularly within addiction medicine.
Company Culture And Values
Our organization emphasizes confidentiality, regulatory compliance, and a collaborative work environment. We strive to cultivate a professional atmosphere that values accountability and quality service delivery, encouraging teamwork among all employees.
Employment Type: Full-Time
The Substance Use Disorder Billing Specialist III is a pivotal member of our dedicated team, tasked with ensuring the efficient billing processes for both Medicaid and private insurance related to addiction treatment programs. This role is integral to the accurate and timely submission of claims for services rendered, as well as the management of follow-up procedures for Medicaid billing and reimbursement verification. Upholding client confidentiality and information security in accordance with HIPAA regulations is paramount.
Key Responsibilities
- Ensure that billing operations align with departmental protocols and comply with federal, state, and payer regulations.
- Validate that billing documentation for clients meets all requirements for Medicaid reimbursement.
- Verify Medicaid coding to facilitate timely payment.
- Conduct meticulous reviews of service notes and billing data on a daily, weekly, and monthly basis.
- Generate billing information in Methasoft and submit to the Billing Coder Supervisor.
- Transmit accurate billing information electronically to Medicaid carriers and stay informed on any carrier rule updates.
- Engage with claim clerks in Medicaid concerning disputed claims and follow up on outstanding bills.
- Review and resubmit denied claims, ensuring all necessary adjustments are made.
- Maintain comprehensive and secure records of billing documentation in compliance with state guidelines.
- Assist in preparing reports on Medicaid billing for management review.
- Exceptional verbal and written communication abilities.
- Strong aptitude for accurate documentation and report generation.
- In-depth knowledge of addiction medicine billing and collection practices.
- Proficiency in Methasoft or comparable medical billing software.
- Capability to operate both autonomously and collaboratively within a team environment.
- Effective problem-solving skills with a solution-focused approach.
- An Associate degree in Accounting, Medical Billing, or a related field, accompanied by three years of medical billing experience; or a Bachelor's degree in Accounting, Healthcare Administration, or a related discipline, with one year of medical billing experience; or possess a Certified Coding Specialist (CCS) or similar credential.
- A valid Washington State Driver's license and eligibility for tribal insurance.
- Preference will be given to Lummi/Native American/Veteran applicants.
We are committed to fostering professional development for our staff, providing exposure to diverse aspects of medical billing, particularly within addiction medicine.
Company Culture And Values
Our organization emphasizes confidentiality, regulatory compliance, and a collaborative work environment. We strive to cultivate a professional atmosphere that values accountability and quality service delivery, encouraging teamwork among all employees.
Employment Type: Full-Time
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