Billing Specialist chez EXCEPTIONAL PARENTS UNLIMITED

Description

Job Summary: The Billing Specialist will manage the day-to-day administrative operations and play a vital role in billing for programs and services. In addition, the Billing Specialist will also provide CalAIM-specialized billing services along with other billing duties.  

Essential Functions:

• Supports and promotes the mission of the Agency.
• Prepare and submit invoices within 48 hours from time of service.
• Prepare and submit claims within 48 hours from time of service. 
• Collaborate with other departments to obtain and analyze additional information; to record and process billing effectively.
• Ensures that maximum reimbursement is obtained through billing and coding, or all services rendered. Responsible for correcting, completing, and processing claims of all respective payer codes.
• Daily monitoring of assigned queues for claim progression directly impacting timely payments, manages the claims process, including accurate and timely claim creation, follows-up and correspondence with required entities.
• Prepares and submits error free claims to third party payers either electronically or by paper per the payor guidelines.
• Maintain, manage, and process child/family records and information in a confidential manner that meets HIPAA and other applicable confidentiality regulations. 
• Responsible to ensure that all stages of revenue cycle are completed and are accurate. From claim submission, denial management, to review of payment postings and reporting.
• Keeps and maintains a safe and clean work environment.
• Prepares and keeps an organized filing system for all program documents related to billing. Submit monthly reports of billing activities and developments to the Director and/or President/CEO.
• Maintains positive, cooperative, life-giving team dynamics and environment.
• Attends training and regular meetings.
• EPU facility hours are Monday – Friday; 8:00 AM – 5:00 PM; with some exceptions based on business needs. Positions hours may vary on occasion depending upon the needs of the business.
• Other duties and responsibilities as required by the Sr. Manager, Program Director, or President/CEO.

Requirements

Knowledge, Skill and Experience:

Education: High school diploma or equivalent; Education or background in Accounting, Finance, or a related field of expertise.

Skills: Must have strong communication skills written and verbal, planning/organizing, detail orientated, information gathering, identifying solutions, summarization, listening comprehension, goal setting, multi-tasking, teamwork, and collaboration, initiative and able to make independent decisions within guidelines, code of ethics.

Experience:

• 2+ years’ experience or operational background in fields such as billing, accounts receivable, or financial administration, preferably in a healthcare or social service setting.
• Experience in recognizing and resolving billing related issues. 
• Experience in ensure agency is up to date in billing requirements and compliance.
• Experience in healthcare, Medi-Cal or CalAIM billing practices and regulations is highly desirable but not required.
• Experience working with medical billing codes, insurance reimbursement processes, and relevant state and federal regulations.
• Experience working with financial software and billing systems, particularly those used in healthcare preferred.
• Accurate data entry at the rate of 45 WPM or 11250 KPH.
• Experience working with Microsoft Office Suite, particularly Excel, Word and Outlook.
• Experience in coordinating with internal operations, such as program managers and service providers to ensure accurate billing for services rendered.

Physical Demands:

Typical Working Condition: Position works from the EPU facility. The position requires the ability to sit and work on a computer for extensive periods of time. Position requires fingering (fine dexterity), repetitive hand and wrist motions.

Equipment Used: Computers, printers, telephones, and fax machines. Requires the ability to operating of a vehicle for local travel.

Essential Physical Tasks: Must be able to sit for long periods of time, working with a keyboard, computer screen.  

This position description may not be an exhaustive list of all duties, knowledge, or abilities associated with this classification; however, it is intended to accurately reflect the principle job elements. Related duties, knowledge, or abilities to those expressly stated may also be required for successful performance of the position.