Medical Billing Specialist

SUMMARY

• The Medical Billing Specialist is responsible for a variety of duties which may include routine billing, payment posting, and
  problem solving for various payers, including: ODMHSAS, Medicaid, Medicare, private pay, and various insurance.
  In addition, may be responsible for billing and posting for specialty contracts. Responsible for clear, detailed
  communication with the clinical and billing staff and with payers and clients regarding various insurance and
  payment related issues. Will research and resolve client insurance claims that are denied or uncollected and work
  with the clinical staff members to resolve billing problems.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned

• Adheres to agency policy and procedures, CARF and DMHSAS standards and criteria, federal and state
  confidentiality rules and regulations, and any special funding source requirements.
• Supports and promotes a service environment for individual in need of behavioral health and/or co-occurring
  services that is recovery focused, welcoming, and attentive to the needs of individuals who may have experienced
  trauma in their lives. Attends annual core competencies training in relationship to individuals with co-occurring
  disorders or who have experienced trauma in their lives.
• Verifies billing data on source documents for completeness and accuracy and revise errors.
• Obtains insurance verification on all new clients.
• Recognize problem accounts and notify appropriate staff or supervisor to assist in problem resolution.
• Coordinate and collect necessary information from staff of payers for claim adjudication.
• Performs accurate data entry functions in accounts receivable system and/or DMHSAS data collection system
  meeting closing time lines determined by the system.
• Completes and verifies information on financial agreements of clients, as assigned by supervisor, and obtain copy of
  insurance card or other evidence of third party coverage. Insure information is correct in computer system
  Interacts with staff, clients, payer and agencies to answer questions, obtain information, and resolve issues.
• Enters various services into the computer system.
• May collect fees for services provided and issues receipt in accordance with established procedures.
• May schedule future appointments and answers inquiries.
• Performs routine duties of other billing staff, as assigned.
• Travel may be required
• Provides backup to front desk as needed.
• Reimbursement for use of personal vehicle will be made in accordance with agency policy and procedures.
• Performs other related duties, as assigned.

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 and/or EXPERIENCE

• High school diploma or GED with one year experience processing and submitting medical claims or equivalent
  combination of education and experience.

EOE Statement

• We are an equal opportunity employer. All qualified applicants will receive consideration for employment without
  regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other
  characteristic protected by law