Billing and Collection Specialist

Description

The position is part-time/hybrid, up to 10 hours per week, with a flexible schedule.

JOB SCOPE:

Responsible for reviewing medical billing claims for two outpatient behavioral health clinics and handling all outstanding balance amounts. Responsibilities include troubleshooting claims issues with MCOs, private insurance companies, and consumers, tracking and collecting individual co-pays, monitoring Medicaid Spenddowns, and other billing related activities. Requires effective communication and coordination with clinic administrators and front desk staff.

ESSENTIAL FUNCTIONS:

Responsibilities include but are not limited to the following:

• Assists in conducting insurance checks for new and existing consumers.
• Reviews billing remittance reports and addresses all discrepancies and denials.
• Interfaces with MCOs and Insurance Companies to resolve unpaid or underpaid claims.
• Contacts clinic consumers to update inactive policies.
• Assists consumers with obtaining authorizations for care.
• Works with clinic staff to correct missing or incorrect billing information.
• Monitors co-pays and handles all outstanding balance amounts.
• Handles invoicing for private pay clients, including calculation of sliding scale fees.
• Completes documentation for individuals with Medicaid spend downs.
• Reports to management on the status of payment/denial resolutions.
• Conducts telephone screenings where necessary.
• Perform other duties as assigned by supervisor.
  
  

Qualifications

EDUCATION AND EXPERIENCE:

• High School Diploma required, college degree preferred
• Two years experience in billing/collection
• Experience in a behavioral health environment preferred.