Billing Specialist

Position Title: Billing/Claims Specialist

Position Status: Full-Time

Supervisor: Director of Operations

Work location: Elizabethtown/Lexington/Indiana

Status: E

Pre-Employment Requirements:

• Drug test.
• Criminal Background check – over one year since prior conviction
• TB skin test: Must have a test or provide proof of one within the past year.
• Must have a valid driver’s license with reliable transportation.
• Prefer bachelor’s degree in a human service field, finance, accounting, or business administration but not required. A combination of education and/or experience must equal 3 years.
• Required experience in Commercial and Medicaid insurance.

Position Summary: Responsible for overseeing the billing process for clients. The duties include processing payments on behalf of a client, maintaining organized financial records to aid reporting, and calculating bill totals by looking through previous financial statements.

Skill Sets: Maintain a supportive and encouraging working relationship with personnel and clients. Excellent verbal and written communication skills are required. Solid understanding of basic accounting principles, fair credit practices, and collection regulations. Calculate, post, and manage accounting figures and financial records. Data entry skills along with a knack for numbers. Hands-on experience in operating spreadsheets. Proficiency in English and in MS Office. Customer service orientation and negotiation skills. Maintain a high degree of accuracy and attention to detail.

Physical and Environmental Demands: Visual acuity and manual dexterity are needed for the required paperwork. Frequent talking and hearing are required when communicating with co-leaders, families, and other service providers. The physical demands are light with walking, standing, and occasional stooping.

Job Responsibilities:

• Able to provide quality customer service to personnel, clients, families and stakeholders.
• Helps maintain the health, safety and welfare of personnel, clients and stakeholders.
• Ensure the agency is operating under CARF accreditation standards.
• Ensure that state and federal licensure and regulations are being adhered to.
• Make decisions in relation to day-to-day operations and consult with CEO o
• Process accounts and incoming payments in compliance with financial policies and procedures.
• Perform day-to-day financial transactions, including verifying, classifying, computing, posting, and recording accounts receivables data.
• Reconcile the accounts receivable ledger to ensure that all payments are accounted for and properly posted.
• Verify discrepancies and resolve clients’ billing issues.
• Assist with ASAM authorizations for all levels of care.
• Verify commercial and Medicaid insurance utilizing the KYMISS and/or Availity systems.
• Utilize the current EMR system to gather information for authorizations, billing issues, etc.
• Manually rebill claims in the EMR system and/or Availity if needed.
• Assist in verification of accuracy of CPT codes and modifiers.
• Assist qualified clients in obtaining and maintaining insurance through the KYNET system.
• Other duties as assigned.

General Standards:

• Exemplify Core Values
• Follows the Ethical Code of Conduct
• Follows the Chain of Command
• Maintain Confidentiality of all client information.
• Maintain a safe environment for recovery.
• Maintains all requirements for job duties to include but not limited to TB skin screening and any continuing education requirements necessary.

I understand and accept the responsibilities as identified.