Facility Billing and Collections Specialist ensures financial procedures are
completed for all clients of Connections Wellness Group who are interested in
the PHP/IOP program. Facility Specialist
interviews incoming patients to retrieve all pertinent financial
information. Facility Specialist
verifies insurance information with third party payers to obtain an accurate
benefit quote. Facility Specialist is responsible for filing the claims to the
insurance companies in a timely fashion and following up on the claims until
the payments are received. Specialist is
responsible for providing financial posting services which may include entering
receivables and payables, printing and balancing data entered in to the system,
performing basic computer system maintenance, preparing contracts, updating
logs, and contacting vendors and payers.
In addition, the facility specialist ensures that the collection of
payments from insurance is in a timely and accurate manner. Facility Specialist contacts insurance companies
and clients of the clinic via oral and written communication in an effort to
collect funds for services rendered. Facility Billing Specialist is in close
contact with the U/R department, the Outpatient team and the Vice President of
the Business Office to ensure the patients financial concerns are addressed
before the patient is admitted into the program.
1. Provides data processing support to ensure
proper and timely entry of payables and/or receivables within the deadlines
2. Provides receivable processing support for
the preparation of various facility reports and statistical reporting.
3. Prints and balances all daily and monthly
receivable reports and updates files as directed by the Business Office
4. Ensures accounts receivable and accounts
payable postings are current and accurate; makes adjustments as requested.
5. Inputs all charges, payments, and
adjustments to patient accounts within an acceptable time frame of charge
6. Ensures all batches are balanced within the
appropriate time frame.
7. Provides support for admissions and new
clients to the Facility- including insurance verification, financial
counseling, prior authorizations, and single-case agreements.
8. Audit insurance verifications to ensure
client accounts are accurate when presented to the clients and/or third-party
9. Provides communication for admissions to all
pertinent staff at the Facility.
10. Verifies insurance for all levels of care,
including level IV clients.
11. Submit claim corrections as applicable.
12. Creates and communicates payment agreements
with clients of the Facility.
Note: The essential job functions of this position
are not limited to the duties listed above.
KNOWLEDGE, SKILLS, AND ABILITIES
effectively and efficiently in an independent role.
to remain calm while working efficiently under stressful conditions.
have excellent interpersonal communication skills, to include written and
verbal, in order to effectively communicate insurance benefits to the treatment
4. Ability to accurately read Explanations of
Benefits from third-party payers.
5. Working knowledge of billing systems in
identified electronic health record systems.
6. Knowledge of common forms used to submit
claims to third-party payers: UBO4, CMS 1500.
7. Build and maintain relationships with
designated representatives of third-party payers.
PHYSICAL, MENTAL, AND SPECIAL DEMANDS
1. Ability to sit for long periods of time
2. Ability to reach above and below the waist,
turn, twist and to manipulate small tools (copier, computer, telephone,
typewriter, calculator, safe, facsimile machine).
3. Ability to see well enough to read
handwritten and typewritten material.
6. Ability to handle a variety of repetitive
tasks at a moderate level.
8. Available to work varied hours (i.e.
evenings) as required, may be on call as needed.
9. Ability to travel between facility
locations, and at times, the corporate office.
to drive a motor vehicle to designated sites.
to handle multiple projects and tasks under deadlines and with short notice.
in medical billing and coding is preferred.
Experience: A minimum of two (2) years’ experience in a
Certified Coding Specialist preferred, Certified Coding Assistant with 2 years’
experience is acceptable.
Additional Requirements: A
working knowledge of the DSM-V, ICD-10, CPT, Rev, HCPCS, and denial codes.
Vertava Health is an EEO employer - M/F/Vets/Disabled