BILLING SPECIALIST

CAYA Collaborative Care; Bowling Green (KY); On-site; USD 20,000 - 29,000; Full time

Job summary

CAYA Collaborative Care in Bowling Green, KY is seeking a Billing Specialist responsible for the accurate and timely processing of claims, maintaining accounts receivable for assigned payers, and reporting issues to the Billing Manager. The role requires data entry and strong communication skills to support clients with balances.

The position involves submitting electronic claims through Availity Revenue Cycle Management and other clearinghouses, handling secondary claims, correcting errors,

Qualifications

• High school diploma or equivalent is required.
• 1–2 years of claims and billing experience preferred.
• Billing or administrative experience in developmental disabilities and/or behavioral health is preferred.
• Microsoft Office/Excel is required.
• Availity and KY Medicaid experience are helpful.
• Comprehensive knowledge of ICD-10, CPT, and HCPCS coding.

Responsibilities

• Managing payer and patient accounts receivable.
• Working correction tickets for billings before or after payment.
• Submitting claims electronically through Availity Revenue Cycle Management and other clearinghouses.
• Submitting secondary claims through Availity Revenue Cycle Management and preparing and mailing paper claims.
• Making corrections to claims scrubbed for errors in Availity.
• Working claim denials through CareLogic.
• Calling payers to appeal denials and coordinating with payer reps to correct denials.
• Answering client questions regarding account balances.
• Data entry.
• Other duties as assigned by Revenue Cycle Manager or Billing Supervisor.

Skills

2 years billing experience

Billing knowledge in health care

Microsoft Office/Excel

Availity

CareLogic knowledge

ICD-10 CPT HCPCS coding knowledge

Education

High school diploma or equivalent

Tools

Availity

KY Medicaid

Job description

Job DetailsJob Location: LifeSkills Corporate 0AV58 - Bowling Green, KY 42102Position Type: Full TimeEducation Level: High SchoolSalary Range: $18.03 - $18.03 HourlyTravel Percentage: NoneJob Shift: 1st shiftJob Category: FinancePOSITION SUMMARY: The Billing Specialist is responsible for the accurate and timely processing of claims. Billing Specialist will maintain AR for assigned payers and report any ongoing issues to Billing Manager. Billing Specialist will be expected to reach out to payers when issues arise.

DUTIES AND RESPONSIBILITIES:

• Managing payer and patient accounts receivables
• Working correction tickets for billings before or after payment has been received
• Submitting claims electronically through Availity Revenue Cycle Management and other clearinghouses
• Submitting secondary claims through Availity Revenue Cycle Management and preparing and mailing paper claims
• Making corrections to claims that have been scrubbed for errors in Availity before submitting
• Working claim denials through CareLogic
• Calling payers to appeal denials and working closely with payer representatives to correct erroneous denials
• Answering client questions regarding account balances
• Data entry
• Other duties as assigned by the Revenue Cycle Manager or Billing Supervisor

QUALIFICATIONS:

• High school diploma or equivalent is required
• Prior experience of 1 – 2 years in claims and billing preferred
• Billing or administrative experience in the Developmental Disabilities and/or Behavioral Health (Mental Health and Substance Use) field is preferred
• Microsoft Office/Excel is required
• Availity, KY Medicaid, software experience is helpful
• Comprehensive knowledge of ICD-10, CPT, and HCPCS coding

JOB REQUIREMENTS / EXPECTATIONS:

• Successful candidates must possess good oral and written communication skills as well as the ability to multitask and work efficiently in fast-paced environment. Must pass a legally required Criminal Record Check and a Sexual Offender Registry check.
• Must be able to work in a group setting with other billing specialists.
• The applicant hired into this role will be evaluated against company and department goals, objectives, and performance factors annually.

CORE VALUES:

All employees must be willing to live our company's core values.

• Integrity– Exhibiting the highest moral, ethical and legal standards. Doing the right thing – even when no one else is looking.
• Teamwork– Putting team success over personal success. Actively valuing the strengths and talents of others.
• Trust/Respect–Seeing and believing in the good intentions of others. Interacting with others in a way that makes them feel valued. Listening without judging. Offeringunderstanding and acceptance.
• Care/Compassion– Demonstrating unconditional kindness, concern and empathy. Exhibiting genuine concern for others.
• Ownership/Accountability–Taking personal responsibility for one’s work, actions and feelings. Accepting responsibilityfor and learningfrommistakes.