Facility Billing & Collection Specialist

Vertava Health Corinth, TX $17.00 to $19.00 per hour
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The 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.

PRIMARY RESPONSIBILITIES

 

1.     Provides data processing support to ensure proper and timely entry of payables and/or receivables within the deadlines given. 

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 Manager.

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 generation.

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 payers.

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

 

 1.    Work effectively and efficiently in an independent role.

 2.    Ability to remain calm while working efficiently under stressful conditions.

 3.    Must have excellent interpersonal communication skills, to include written and verbal, in order to effectively communicate insurance benefits to the treatment team.

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 (8-10 hours),

 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.

10.   Ability to drive a motor vehicle to designated sites.

11.   Ability to handle multiple projects and tasks under deadlines and with short notice.

QUALIFICATIONS

 

Education: Degree in medical billing and coding is preferred.

Experience:   A minimum of two (2) years’ experience in a healthcare facility.

Certification: 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.

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