Full-time Billing Specialist

St. Joseph's Addiction Treatment and Recovery Centers Hybrid Location: Remote / Inpatient Facility - Saranac Lake, NY Position: Full-time Billing Specialist Shift/schedule: Monday-Friday / 8:00a-4:30p Pay Range: $20.00/hr to $29.00/hr Position Summary: A Level I AR Specialist is responsible for client billing, processing charges and/or payment information, entering accurate information into the billing system, claims/denial management and follow up and daily and monthly reconciliations for all agency programs. The Specialist is responsible for billing and collecting all client accounts according to established policy and procedure. In addition, the Specialist is responsible for accurately maintaining account balances on a daily basis, as well as staying current with constantly changing rules and regulations to ensure prompt collection of monies due. Maintenance of financial files for accurate follow up on unpaid balances. Education and Training: High School Graduate. Associates degree in Accounting or Finance or Business Administration or completion of a medical billing specialist course or equivalent experience. Qualifications and Requirements: At least one (1) year experience as a medical biller preferred, or similar Ability to use Microsoft Office Suite (Outlook) Excellent written and verbal communication skills Proven ability to make appropriate decisions based on insurance contract requirements and SJRC policy, as evidenced by meeting standards on performance appraisal. Essential Duties: Billing: Track client bills and third-party insurances in compliance with applicable regulations and contractual agreements. Responsible for assuring that all accounts that are available to be billed are billed within applicable timeframes as established by SJRC policy. This includes new accounts, secondary bills, and re-bills. Responsible for understanding and staying current with SJRC insurance contracts, online or paper provider manuals and monthly bulletins from payers. Demonstrates a thorough understanding of all applicable insurance regulations and contractual requirements as it applies to billing and collecting accounts receivable. Responsible for communicating any significant insurance billing or insurance issues to the Supervisor in a timely manner. Verifies that accurate and complete information is included on the claim form in accordance with specific payer requirements. Process insurance rejections, denial, or requests for additional information in a timely manner. Responsible for changing financial class, corrections to the system as requested by the individual programs, transferring balances to other insurance or client, and documenting account for all appropriate rejections. Responsible for following up with insurance company and providing missing information related to claims denials and submitting re-bills as indicated. File necessary appeals to insurance company for any denial reason not accepted as valid. Works claims denial diligently to resolve outstanding issues and secure claims payments. Identify all accounts which have been billed and for which there is still an open balance and follow up with rebilling or otherwise communicating with third party payers or clients as appropriate. Posting: Processes 835files for appropriate upload into the EHR system. Processes Explanation of Benefit statements including calculating contractual allowance and verifying accuracy of payment in a timely manner and in accordance with contract terms. Responsible for posting of payment, transferring balances appropriately and documenting the remaining balance Electronic Health Records: Demonstrates thorough understanding of client accounting and electronic billing information system. 837 / 835 data files inside EHR system Claims Clearinghouse Understand system structure, operation, and payer/contract setup. Medical: Responsible for monitoring statements and communicating with outside companies for the purpose of Medications and Laboratory test(s); to coordinate correct client and billing information and/or processing/validating invoice processing slips for payment under SJRC. Responsible for monitoring and communicating with Adirondack Health and/or outside medical providers to coordinate correct client and billing information. Work with Adirondack Health in cross-walking charges to hospital Medicaid rates on client statements. Collaborate with Medical Team(s) to ensure accuracy in information being sent with orders and any to follow up with any additional information required for claim appeals Other: Provides cross coverage to other team members in the department. Prepares, reviews and send client statements. Prepare IPS for refunds and recovery to clients or payers, as needed. Other duties as assigned.

Apply Now