Billing Specialist

Bournewood Health Systems; Boynton Beach (FL); On-site; USD 38,000 - 62,000; Full time

Job summary

Bournewood Health Systems in Boynton Beach, FL is seeking a Billing Specialist to enter patient demographics into the billing software, submit billable claims to insurers, and verify insurance authorization before billing.

You will work with the Utilization Review process, ensure policy accuracy, correct rejected claims, and maintain HIPAA confidentiality while delivering excellent customer service.

Qualifications

• High School Diploma or GED required; Bachelor’s degree preferred.
• Minimum 2–3 years’ experience in Substance Abuse/Mental Health medical billing and coding required.
• Knowledge of third-party payers and in-/out-of-network billing.
• Proficiency with Word, Excel, PowerPoint, Outlook, EMR systems and billing software.

Responsibilities

• Enter patient demographics into billing software.
• Enter and submit billable claims to insurance companies.
• Cross-check in EMR to ensure authorization is on file before submitting claims.
• Verify client policy is active via portal during billing.
• Filing corrected claims and fixing rejected claims.
• Update action list for all UR issues while billing.

Skills

Strong communication

Independent work

multitasking

Education

High School Diploma or GED

Bachelor's degree (preferred)

Tools

Word

Excel

PowerPoint

Outlook

Electronic Medical Records

Billing Systems

KIPU

Collaborate MDS

Job description

Billing SpecialistJOB CATEGORY |AdministrativePOSITION TYPE |Full-TimeFLSA | Non-ExemptRISK EXPOSURE| LowIMMEDIATE SUPERVISOR |Director of BillingPOSITION FUNCTION/OVERVIEW:Enter all patient demographics into the billing software. Entering and submitting Billable claims to insurance companies, cross checking in Medical EMR to ensure authorization is on file prior to submitting claims. Verifying client policy is active via portal during the billing process before submitting claims. Filing corrected claims and fixing all rejected claims. Updating Action list for all UR issues while billing.PRIMARY DUTIES/RESPONSIBILITIES:• Promote the mission, values, and vision of the organization.• Provide excellent customer service for clients; practices confidentiality and privacy protocols in accordance with HIPAA requirements.• Research plans and provides the Utilization Review team with information about pre-certification, and policy details.• Work with Utilization Review Specialists to achieve the highest levels of care for the client.• Ensure all required insurance standards and regulations are met.• Performs other duties as required.QUALIFICATIONS REQUIRED:• High School Diploma or GED equivalent with combination of education and work experience, required; bachelor's degree, preferred.• Minimum of two (3) years’ experience in Substance Abuse/ Mental Health Medical Billing and Coding• Knowledge of Third-Party payers, billing requirements for in network and out of network providers• Knowledgeable in the field of Substance Abuse treatment.• Relevant computer software and hardware applications proficiency – Word, Excel, PowerPoint, Outlook, Electronic Medical Records, Billing Systems and/or other scheduling applications; KIPU preferred, Collaborate MDSKILLS:• Strong communication skills, both written and verbal.• Ability to work independently, as well as part of a team.• Manage multiple tasks and set priorities.• Ability to handle highly sensitive and confidential information.• Ability to work in a fast-paced, high-energy environment.• Excellent interpersonal and customer-facing skills.• Ability to work accurately, with attention to detail.This list of essential functions is not intended to be exhaustive. Bournewood Hospital, MA reserves the right to revise this job description as needed to comply with actual job requirements.PHYSICAL REQUIREMENTS: (N=needed P=preferred)Sitting N Standing N Walking N Lifting N Carrying N Kneeling N Pushing/Pulling N Bending/Stooping N Climbing P Reaching N Crawling/Crouching n/a Repetitive Motions P Transporting n/a Other ( )I