Billing Specialist/Accounting Clerk

*This position is eligible for a $1,500 signing bonus

SUMMARY: The primary responsibility of the Billing Specialist/Accounting Clerk is organizing patient medical costs and sending invoices to collect payment from patients and their insurers.  Duties include calling patients to discuss payment and develop reasonable payment plans, entering patient data into administrative systems and recording information about outstanding claims.  Other duties include entering invoices, following up with past due accounts, submitting insurance claims, administrative, reception, filing, data entry, clerical, and ancillary support functions. As time allows, s/he will assist the Administration Director with the oversight of general office administration.  All his/her activities as an employee of JHCCC will be performed in an ethical, professional manner in accord with the policies and procedures of MHRS JH and will be subject to the supervision of the Administration/Finance Director.

ESSENTIAL JOB FUNCTIONS

Responsible for the timely completion of all billing functions including maintaining accurate records of all patient accounts, recording charges, payments, submitting reimbursement requests to all payers, and following up on any denials.

Requirements:

• High school graduate or equivalent.
• One (1) year experience of medical billing or any equivalent combination of experience, training and/or education.
• Certified Professional Coder (CPC) certification and FQHC experience preferred.
• Experience with QuickBooks entering invoices.
• A clear understanding of, and commitment to, the principles of confidentiality in mental health work.

Knowledge, Skills, and Abilities:

• Working knowledge of CPT and ICD10 codes and medical terminology.
• Experience in healthcare industry billing practices including health information technologies and applications.
• Ability to work independently and to perform assignments to completely within time parameters.
• Skill in establishing and maintaining effective working relationships with other employees, patients, organizations and the public.
• Ability to read and interpret insurance explanation of benefits.
• Ability to communicate effectively and professionally in writing, over the phone, and in person.
• Ability to identify billing/coding errors and request resolution from clinicians.
• Proficient in Microsoft Office including Outlook, Word and Excel.
• Maintain compliance with Federal, State, and payer regulations.
• Maintain compliance with all company policies and procedures.
• Be service-oriented with the ability to pay attention to details in a fast-paced environment.

Duties and Responsibilities:

Billing

• Review medical records to ensure proper coding based on current coding guidelines and conventions.
• Ensure medical records are signed by appropriate parties.
• Effectively manage coding and billing related inquiries from providers or patients.
• Ensure that claims are submitted in a timely manner with a goal of zero errors, to include insurance and demographic information.
• Timely follow up and resolution on insurance claim denials, exceptions or exclusions.
• Identify insurance payer denials and work with insurance payer on resolution, to include appeal submission with appropriate documentation.
• Identify coding and billing errors and work with clinical staff on charge entry resolution.
• Timely charge acceptance/processing and appending necessary modifiers.
• Identifies patterns of billing errors, inaccurate payments, posting errors and communicates any needed system changes to direct Supervisor.
• Creates and maintains meticulous records of follow-up efforts via the billing system.
• Reduces overall delinquent patient AR.  Sends patient collection notices when necessary.
• Ability to comfortably work with patients on income information for sliding scale and/or payment plans.
• Understands and adheres to HIPAA and PHI guidelines.
• Makes necessary demographic changes to patient accounts to ensure accuracy for future billing.

Accounting/Clerical

• Provides professional and courteous customer service at all times.
• Working knowledge of current grants, funds, and other programs available to patients for their healthcare.
• Timely communication to the Leadership Team regarding trends with payors/front desk and other issues that are potentially disruptive to cash flow.
• Review, verify and enter all AP invoices.  Submit invoices that need approval to proper persons.
• Work with Accounting Manager to ensure daily credit card batch reports are run and reconciled with patient’s accounts.
• Daily, prepare outgoing post and take to post office; pick up incoming mail and distribute internally.
• Document and send faxed documents; route incoming faxes as appropriate.
• Complete or assist in preparing Medicare and other payer provider applications on behalf of qualified MHRS JH staff members and maintain and update all qualified staff applications with payers.

General Administration

• Regular and predictable on-site attendance is an essential function of this position.
• Perform other job-related duties as assigned.

WORK ENVIRONMENT:

The Billing Specialist/Accounting Clerk will work primarily in the offices of MHRS JH.

Ability to sit and work in front of a computer work terminal for 8 hrs/day.

Ability to lift up to 50lbs.