Billing Specialist

ADP, Inc.; Toledo (OH); On-site; USD 38,000 - 46,000; Full time

Benefits offered by this job

Health insurance

Life insurance

Paid time off

Vision insurance

IRA plan with employer match

10 paid Holidays

Job summary

Empowered for Excellence in Toledo, OH is seeking a Billing Specialist to manage billing postings, denials, and payer communications. You will work with clinical and billing staff and payers to ensure accurate claims processing and timely resolution of issues.

The role requires 3–5 years in data entry or billing processing, with a strong attention to detail and excellent communication skills. Behavioral health experience and Carelogic familiarity are preferred.

Qualifications

• High school diploma or GED is required.
• 3–5 years of data entry or billing processing experience.
• Behavioral health setting experience and Carelogic systems preferred.

Responsibilities

• Adhere to agency policies and procedures.
• Verify correct client payers and update EHR.
• Prepare, review, and transmit client claims using billing software.
• Research denied claims and correct/rebills/appeals within timeframes.
• Retrieve 835s, EOBs, and electronic files for payment posting.
• Post and balance claim payments promptly.
• Provide daily financial transaction summaries to supervisor.
• Stay informed of payer updates and issues.
• Maintain organized records and files.
• Ensure internal controls through checks and balances.

Skills

Attention to detail

Verbal and written communication

Problem solving

Independent worker

Education

High school diploma or GED

Tools

Carelogic

Billing software

Job description

Administration-Empowering Youth Full Time Toledo OH, US

3 days ago Requisition ID: 1188

General Summary

The Billing Specialist is responsible for a variety of duties, as assigned by supervisor, which may include routine billing payment posting and problem solving for various payers, including insurance, HMO, Medicaid, Medicare and private pay. The Billing Specialist may be responsible for obtaining and entry of prior authorizations. This position is responsible for clear, detailed communication with the clinical and billing staffs and with payers and clients regarding various insurance-related and payment-related issues. Performs related work as required.

Knowledge, Skills and Abilities:

Knowledge of medical billing procedures, practices and protocols; must have excellent oral and written communication skills; must be able to problem solve; must be able to operate independently in the absence of supervisor; ability to meet changing demands and exhibits a high degree of professionalism and communicates effectively; demonstrated ability to meet deadlines; demonstrated ability to professionally approach and interact with all levels of staff, and other agencies and the public; ability to abide with the agency’s professional code of ethics; must be detailed and deadline oriented; working skill in following established procedures; working skill in preparing financial or statistical reports; some skill in reading and understanding job related documents; skill in maintaining confidentiality of information and materials; good knowledge of basic mathematics.

Responsibilities:

• Adhere to agency policies and procedures.
• Verify correct client payers and properly update EHR.
• Prepare, review, and transmit client claims in a timely manner using billing software including electronic and paper claim processing.
• Conducts appropriate research for any denied claim and corrects, rebills or initiates appeals within the designated timeframes.
• Retrieves 835’s, EOB’s and electronic files as required for payment posting.
• Post and balance claim payments in a timely manner.
• Provide summary of daily financial transactions to supervisor before close of business each day.
• Stay informed of updates, changes and on-going issues with all payer sources.
• Prepare and accurately/systematically maintain a variety of organizational records and files.
• Processes a wide variety of complex records, reports, applications, and other transactions as required.
• Verifies that internal checks and balances are operating efficiently to maintain internal control.
• Makes recommendations for modifications in office forms and procedures.
• Performs other related duties as assigned.

Qualifications:

Minimum qualifications include a high school diploma and/or GED and 3 to 5 years’ experience in data entry and/or processing billing. Excellent attention to detail required. Experience working in a Behavioral health setting and experience in Carelogic systems preferred.

• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• IRA plan with employer match
• 10 paid Holidays

Weekly schedule: Monday to Friday

Empowered for Excellence provides equal employment opportunities to all employees and applicants for employment regardless of race, color, age, sex, creed, national origin, economic status, sexual orientation, or physical disability. In addition to federal law requirements, Empowered for Excellence complies with applicable state and local governing nondiscrimination in employment in every location in which the agency has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.