Billing Specialist – Huron or Madison

JOB TITLE: Billing Specialist

LOCATION: HURON

REPORTS TO: Business Office Manager

FLSA STATUS: Non Exempt

DEVELOPED: 3/2021

 

SUMMARY

Responsible for a variety of tasks including:  collecting, posting and managing account payments, submitting claims and following up with insurance companies and other pay sources. Work within a team of other billing specialists, credentialing specialists, business office and administration.

 

EXPECTATIONS

Community Counseling Services expects employees to be welcoming to consumers, including those with co-occurring disorders, and engaging consumers at their current stage of recovery. Services provided will be in accordance with the plans and guidelines as established by Community Counseling Services and the State Division of Behavioral Health.  Portray and encourage civility to all clients, customers, employees, community partners and vendors.

 

QUALIFICATIONS

Education and Experience

  • Bachelors degree in Business or Accounting (or related field) preferred;
  • Two years or more insurance billing/coding experience
  • Or equal combination of education and or experience in insurance billing/coding.Certificates, licenses, registrations
  • Valid South Dakota Driver’s license
  • Must not be excluded from participating in Medicare, Medicaid, and any Federal health care program, as provided by the OIG, USDHHS.

 

Other qualifications

Computer software skills in MS Office Suite, especially Excel spreadsheets,10 key, insurance coding and billing cycles, contracts with insurance companies and other pay sources.  Be able to make judgment calls in negotiating with clients, insurance companies and payers.  Must demonstrate excellent written and verbal communication skills, as communicating with clients, staff and various pay sources will form a large part of the job. Must have the ability to multitask and manage time effectively, and have outstanding problem-solving and organizational skills with the ability to prioritize tasks.

Supervisory Responsibilities None

 

ESSENTIAL DUTIES/CRITICAL JOB ELEMENTS

  • Generate claims processing procedure.  Verify that coding by counselors is correct, and pay source is accurate in order for claims to be created.  Correct coding errors in Practice Management software so that claims will bill correctly.
  • Prepare invoice batches to submit electronically on a weekly basis to Department of Social Services, SD Medicaid, Medicare, and a variety of other pay sources in a timely manner.
  • Ensure the patient’s medical information is accurate and up to date, including insurance information.
  • Prepare invoices for private pay services.
  • Assist clients with payment plans.
  • Follow up with on claims with all pay sources to ensure that all denials are corrected, rebilled and paid in a timely manner.  Follow up and investigate and appeal denied claims.
  • Enter and post all payments to practice management software.
  • File or scan into practice management software all completed insurance claims along with their Explanation of Benefits.
  • Maintain control over Accounts Receivable collection efforts with clients and collection agencies.
  • Print out and mail billing statements and collection letters to clients on a monthly basis.
  • Investigate and resolve customer queries.
  • Create and develop reports in order to generate specialized reports of data for departments in the agency.
  • 40 hours per week.
  • Maintain confidentiality regarding privileged administrative and client information in a professional manner.
  • Add or update service codes and associated revenue links as needed in Practice Management software.
  • Cross train and assist other business office staff as needed.
  • Other duties as assigned.

Download an application and mail or email it to Community Counseling Services, Human Resources mehofer@ccs-sd.org.

MELISSA HOFER COMMUNITY COUNSELING SERVICES 357 KANSAS AVE SE HURON, SD  57350