What are the responsibilities and job description for the Billing Specialist position at Shoreline Behavioral Health Service?
Duties include all aspects of commercial insurance, managed care organizations (MCO) and Medicaid billing requirements such as monitoring claim status and researching rejections, outstanding claims, and denials to ensure timely reimbursements. Documenting related account activities, posting payments for various insurance companies, discussing insurance coverage with clients, and auditing accounts. Troubleshooting errors and submitting batches to DHHS electronically. Requesting prior authorizations for services from insurance providers and monitoring to insure continued coverage. Verifying client insurance coverage and obtaining necessary authorizations.
QUALIFICATIONS: High school diploma or equivalent, Medical Billing and Coding Certification and minimum of 4 years of experience in medical or behavioral health billing for Commercial Insurance, Managed Care organization (MCO) and Medicaid or related role required.
Associate degree in healthcare administration or related field preferred. Knowledge of Emedix system and Carelogic is desired.
Proficient in Microsoft Word and Excel. Strong knowledge of medical collection practices and procedures. Excellent attention to detail and accuracy in data entry and record keeping. Strong communication skills, both written and verbal, with the ability to effectively communicate with insurance companies, providers, and clients. Ability to work independently as well as part of a team in a fast-paced environment.