What are the responsibilities and job description for the Billing Specialist position at Revive Inc?
Summary:
The Medical Billing Specialist at Revive is responsible for managing patient billing and ensuring accurate and timely processing of insurance claims. This role involves coordinating with healthcare providers, insurance companies, and patients to ensure that billing processes run smoothly, supporting Revive’s mission of providing compassionate care to individuals overcoming substance use and mental health challenges.
Essential Duties and Responsibilities:
Collaborate with healthcare providers and administrative staff to ensure correct coding and documentation.
- Prepare and submit complete and accurate claims to insurance providers using standardized formats.
- Actively work with Utilization Review in the case of authorization issues.
- Review and follow up on unpaid or denied claims, ensuring timely resolution.
- Verify patient insurance coverage and benefits and obtain pre-authorizations when necessary.
- Communicate with patients regarding their billing questions and concerns, providing clear explanations of charges and payment options.
- Answer billing questions and educate providers about documentation best practices.
- Process payments from insurance companies and patients, and post payments to patient accounts.
- Maintain accurate and up-to-date patient billing records in the electronic health record (EHR) system.
- Reconcile billing records with financial reports to ensure accuracy.
- Stay informed about changes in insurance regulations and billing practices to ensure compliance.
- Assist in the preparation of monthly billing reports and analysis.
- Provide excellent customer service to patients, insurance companies, and internal staff.
- Other duties as assigned.
Supervisory:
This position does not oversee staff.
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education/Experience
- Minimum of 2 years of experience in medical billing or coding.
- Experience in billing in mental health and substance abuse setting preferred but not required.
- Knowledge of medical billing software and electronic health record (EHR) systems.
Required Skills/Abilities
- Strong knowledge of insurance guidelines.
- Proficiency in medical billing software and electronic health records (EHR) systems.
- Excellent organizational skills and attention to detail.
- Effective verbal and written communication skills.
- Ability to handle sensitive information with confidentiality.
- Strong problem-solving and analytical skills.
- Ability to work independently and as part of a team.
- Excellent customer service skills.
Work Environment:
The work is typically performed in an office setting with limited exposure to noise or other environmental factors.
Physical Demands:
- Prolonged periods of sitting at a desk and working on a computer.
The work environment characteristics and physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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