What are the responsibilities and job description for the Billing Specialist position at The Behavior Exchange?
Billing Specialist
Behavior Exchange-Plano/Frisco/Prosper
Job Title: Billing Specalist
Company: The Behavior Excgange Inc.
Location: Prosper, TX
Job Type: Full-time
SUMMARY OF FUNCTIONS
The Billing & Revenue Cycle Manager will be responsible for managing the end-to-end billing process and revenue cycle operations to ensure timely and accurate reimbursement for services provided. This role involves overseeing billing procedures, optimizing revenue cycle processes, and ensuring compliance with relevant regulations and payor requirements.
COMPETENCIES
- Communication
- Attention to Detail
- Business Acumen
- Time Management
- Results Driven
- Financial Management
- Problem Solving/Analysis
- Collaboration Skills
MAJOR DUTIES AND RESPONSIBILITIES
- Billing Oversight: Manage and oversee the billing process, including the submission of claims, follow-up on denials, and resolution of billing discrepancies. Ensure that all billing activities are completed accurately and on time.
- Revenue Cycle Management: Develop and implement strategies to optimize the revenue cycle, including reducing days in accounts receivable, improving cash flow, and minimizing claim denials.
- Payor Liaison: Maintain relationships with network representatives and other stakeholders with insurance companies/ payors, files appeals, TDI complaints, completes medical records requests, and prepares and participates in audits. Resolution of issues with payors and clients.
- Compliance and Regulations: Ensure compliance with state and federal regulations, payor policies, and industry standards. Stay updated on changes in billing and coding practices and implement necessary adjustments. Credentialing to include CAQH, NPI, NPPES, as well as payor specific requirement.
- Claims Management: Oversee the submission, tracking, and follow-up of insurance claims. Address and resolve any issues related to claims denials or rejections, working closely with insurance companies and payors.
- Reporting and Analysis: Prepare and analyze financial reports related to billing and revenue cycle performance. Provide insights and recommendations to senior management to improve financial outcomes. Develop and use KPIs to ensure visibility for executive team.
- Teamwork: Communicate and collaborate with billing team to ensure customer satisfaction and effective billing/ revenue cycle management.
- Process Improvement: SOP development. Identifies opportunities for process improvements and implements best practices to enhance efficiency and accuracy in billing and revenue cycle operations.
- Patient and Provider Relations: Serve as a point of contact for patient and provider inquiries related to billing and payment issues. Address and resolve concerns in a professional and timely manner. Ensures valid credit cards are on file for all active accounts. Pursue collection efforts as necessary. Evaluate continuation/ suspension of services in the event accounts are delinquent or out of compliance.
- Technology and Systems: Utilize billing and practice management software effectively. Work with IT and software vendors to ensure systems are functioning properly and implement upgrades as needed.
- Financial Audits: Assist in internal and external audits related to billing and revenue cycle. Provide documentation and support as required to ensure compliance and accuracy.
- Third-Party Billing Collaboration: Meet and collaborate regularly with third-party billing companies to ensure timely account collection, reconciliation of accounts, and resolution of any issues related to billing and payment processes.
- Accounting: Completes bank reconciliations, month-end closing, credit card reconciliations, maintains QuickBooks entries, accounting tasks, and is the liaison with accounting & tax teams. Manages Accounts Payable to ensure compliance with budget and timely payments.
- Payroll: Completes scheduling scrub and prepares payroll for processing. Reviews final payroll to ensure accuracy.
- Vendors: Manages vendor communications, expenses, and payments in line with budget.
RESULTS:
- Bills insurance companies and files claims on a weekly basis.
- Manages financial records on a weekly and monthly basis.
- Ensures HIPPAA and AHRNIA for organization to ensure 100% compliance.
- Completes insurance company credentialing when required for organization.
- Reconciles accounts on monthly basis and ensures compliance with budget on a monthly basis.
- Posts payments, processes accounts receivable and accounts payable on a weekly basis.
- Maintains accounts in QuickBooks and in scheduling software on a daily basis.
- Manages budget and finds cost cutting and revenue generating solutions.
- Facilitates weekly billing for all clients.
- Monitors aging of bills and creates report to communicate to leadership on a bi-weekly basis.
- Creates and maintains intensive and detailed schedule updated by noon (next business day) on a daily basis.
WHAT WE VALUE MOST
- Passion for helping others
- Positive "Can Do" attitude
- Pride in the quality of your work
- Inclusive leadership style
- Honesty and integrity
ORGANIZATIONAL RELATIONSHIPS
Reports directly to the Director of Intake
WORK ENVIRONMENT
This job operates in a professional office environment. This role routinely uses standard office equipment.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without reasonable accommodations. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to type, handle objects, tools or controls; reach with hands and arms; climb stairs; talk or hear.
POSITION TYPE/EXPECTED HOURS OF WORK
This is a full-time on-site position. Days and hours of work are Monday through Friday, 8:30 a.m. to 5:30 p.m.
TRAVEL
Travel (if any) is minimal and primarily local during the business day. Periodic travel to local North Texas locations may be required from time to time.
PREFERRED EDUCATION AND EXPERIENCE
Bachelor’s degree in accounting, Finance, Healthcare Administration, or related field preferred.
2 years of experience in billing and revenue cycle management, preferably in an ABA or healthcare setting preferred.
ADDITIONAL ELIGIBILITY REQUIREMENTS
- Verbal and written communication skills necessary to explain complex and/or confidential information
- Ability to provide effective guidance, counsel, and influence at all levels of the organization
- Self-motivated, energetic, able to work in a busy environment with multiple distractions while staying on task
- Team player with the ability to develop effective partnerships and collaborate with a variety of stakeholders at all levels
- In-depth knowledge of billing codes, insurance reimbursement processes, and regulatory requirements.
- Strong analytical skills and proficiency in financial reporting and data analysis.
- Excellent communication and interpersonal skills, with the ability to work effectively with diverse teams and stakeholders.
- Proficiency in billing software and practice management systems.
- Detail-oriented with strong organizational and problem-solving skills.
CLASSIFICATION
Exempt
