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 plays an integral role within our team, responsible for managing the billing processes associated with Medicaid and private insurance for addiction treatment programs. This position entails producing and sustaining precise claims for services rendered in addiction care, overseeing and following up on Medicaid billing, and reviewing remittance advice forms to ensure accurate reimbursement while adhering to HIPAA regulations.
Key Responsibilities
Our organization is committed to the continuous professional development of our employees, providing access to training and advancement opportunities that foster career progression in the specialized field of substance use disorder billing.
Company Culture And Values
We pride ourselves on cultivating a collaborative work atmosphere where each team member plays a vital role in our shared mission of supporting individuals facing substance use disorders. Our values emphasize clear communication, professionalism, and a focus on solutions.
Employment Type: Full-Time
The Substance Use Disorder Billing Specialist III plays an integral role within our team, responsible for managing the billing processes associated with Medicaid and private insurance for addiction treatment programs. This position entails producing and sustaining precise claims for services rendered in addiction care, overseeing and following up on Medicaid billing, and reviewing remittance advice forms to ensure accurate reimbursement while adhering to HIPAA regulations.
Key Responsibilities
- Facilitate the billing operations in alignment with departmental protocols and in compliance with federal and state regulations, as well as payer guidelines.
- Ensure all billing-related documentation contains the necessary information required for Medicaid reimbursement.
- Confirm accurate Medicaid coding for timely payment processing.
- Conduct daily, weekly, and monthly reviews and data entries related to billable services.
- Input and electronically transmit correct billing information to Medicaid carriers, staying informed about carrier rule changes.
- Collaborate with claim clerks in the Medicaid office regarding disputed claims and follow up on outstanding bills.
- Monitor denied claims and resubmit as necessary, maintaining proper documentation as mandated by state guidelines.
- Prepare and submit weekly and monthly Medicaid billing reports for management.
- Uphold client confidentiality and information security in accordance with HIPAA regulations.
- Exceptional verbal and written communication skills.
- Proficient in composing detailed correspondence and reports.
- In-depth knowledge of addiction medicine billing practices and collection processes.
- Familiarity with Methasoft or comparable medical billing software.
- Strong attention to detail and accuracy in billing practices.
- Capacity to work both independently and collaboratively within a team environment.
- Effective problem-solving skills with a positive, solution-oriented attitude.
- An Associate degree in Accounting, Medical Billing, Medical Coding, or a related field, along with three (3) years of experience in medical billing; or a Bachelor's degree in Accounting, Healthcare Administration, or a related field with one (1) year of relevant experience.
- Certification as a Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or similar credential is preferred.
- Must possess a valid Washington State Driver's License and fulfill eligibility criteria for tribal insurance.
- Compliance with pre-employment drug and alcohol testing as well as a criminal background check is required.
Our organization is committed to the continuous professional development of our employees, providing access to training and advancement opportunities that foster career progression in the specialized field of substance use disorder billing.
Company Culture And Values
We pride ourselves on cultivating a collaborative work atmosphere where each team member plays a vital role in our shared mission of supporting individuals facing substance use disorders. Our values emphasize clear communication, professionalism, and a focus on solutions.
Employment Type: Full-Time