What are the responsibilities and job description for the Billing Specialist position at Volunteers of America of Alaska?
Position Title: Billing Specialist
Reports To: Director of RCM
Classification: Exempt; Salary; Full-Time
Direct Report(s): None
Position Overview:
The Billing Specialist is responsible for the account preparation, billing, follow-up, and collection of accounts for Volunteers of America Alaska while ensuring billing practices are ethical and compliant with government regulations and guidelines. The ideal candidate will be exceptionally detail-oriented, persistent, an independent problem-solver, and willing to work a problem to its successful conclusion.
VOA Alaska is a youth-serving organization providing prevention, early intervention, treatment, and recovery supports to youth and families struggling with mental illness and addiction. We are honored to walk with families during these times and provide support and hope through recovery. Our core values are connection, responsibility, courage, innovation, hope, and joy. We are looking for individuals who espouse these core values and align with this mission of services to the community.
Essential Functions, Duties & Responsibilities
- Verifies patient insurance eligibility and benefits.
- Ensures Electronic Clinical Record is complete for client registration and billing.
- Performs admission notifications and service authorizations, and any pre-certification processes necessary for claim payment
- Reviews claims and patient bills for accuracy and completeness.
- Prepares, reviews, and transmits claims, including electronic and paper claim processing.
- Submits client invoices and monthly statements.
- Follows up on and resolves open claims and client balance accounts (work an aging report).
- Resolves Medicaid and other payors claim denials, paybacks, and any other follow-up necessary for accurate billing and claim payments.
- Sets up patient payment plans and works collection accounts.
- Reviews and posts payments though Explanation of Benefits (EOB’s) or electronic files.
- Assists with staff credentialing process for insurances.
- Considers and communicates ways to optimize the Electronic Health Record (EHR) and billing software.
- Resolve EHR failed activities that are not due to missing signatures to capture all potential billable activity into claims.
- Enters communication notes to accounts and claims.
- Provides customer service by communicating with clients via telephone, mail, or in-person.
Other Duties
- Other job-related duties as assigned
Knowledge, Skills & Abilities
All members of the workforce will be expected to demonstrate a commitment to VOA’s vision and mission and consistently demonstrate its values in all areas of their work. Moreover, everyone is expected to demonstrate collaboration and teamwork, accept direction, feedback and coaching, and prove themselves to be a reliable and consistent resource to clients and colleagues.
Specifically, this position requires:
Required
-
Minimum of one-year medical billing and collection experience:
- Electronic and paper submissions
- Centers for Medicare and Medicaid Services (CMS-1500) and Uniform Billing (UB04)
- Able to work independently, take the initiative to get information, and problem-solve.
- Able to review multiple details at a time and identify issues.
- Knowledge of insurance guidelines, payer requirements, and systems.
- Familiarity with Current Procedural Terminology (CPT), Healthcare Common Procedure Coding (HCPC), and Internal Classification of Disease (ICD-10) coding
- Know how to read and interpret an EOB
- Effective communication for phone contacts with insurance payers to resolve issues
- Customer service skills for interacting with clients and family members in crisis
- Able to triage priorities and handle conflict with a calm demeaner.
- Familiar with Health Insurance Portability and Accountability Act (HIPAA) privacy requirements
- Ability to pass a criminal background check in accordance with the current state regulation requirements.
Preferred
- Know how to read and interpret Electronic Data Interchange (EDI) files
- Knowledge of accounting and bookkeeping procedures
- Familiarity with 42 Code of Federal Regulations (CFR)
Working Conditions
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.
- Works in office area. Interacts with staff, consultants, and outside vendors. May be subjected to interruptions throughout the workday.
- While performing the duties of this job the employee is frequently required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is occasionally required to lift up to 25 pounds. The vision requirement includes close vision.