Medical Billing Specialist - *Remote Fridays*

Our Billing Specialist directly contributes to our mission of making autism services personal by timely and accurately billing the services we provide, collecting revenue, and working with families to make sure they feel supported throughout the billing process.

Day to Day (billing specialist)

• Follow up phone calls
• Do research on denied claims
• Submitting claims
• Resubmit claims once corrected
• Insurance follow up
• 40 accounts per day
• Maintain waystar ques at minimum

Training

• 2 weeks in duration
• Shadow a more tenured staff member

SPECIFIC RESPONSIBILITIES:

• Must have ABA billing with CENTRAL REACH experience
• Submit and follow up on Commercial and Medicaid, primary and secondary insurances
• Track and verify clients' Medicaid status
• Develop relationships with PA Medicaid payors to ensure successful processing and payment of claims
• Work and manage claims from all aging buckets including posting and appeals, including resubmission of claims and appropriate adjustments.
• Input & Review billing data for accuracy, including data entry.
• Ensure that billing and collections adhere to all compliance policies and procedures.
• Work with Billing Manager and local clinic team members to ensure accurate billing.
• Follows up on claim resolution from initial billing through final resolution including identifying and correcting billing errors/rejections and denials (denial management investigations & appeals).
• Manage claims submission and AR for assigned clinics.
• Process remittance advices/EOB's to achieve finalized clean claims for payment including researching and correcting denials (Pull EFT back-ups).
• Post and reconcile payments received using system and deposit reports.
• Assist the intake team in completing required Medicaid documents for new clients and clients in need of reassessment
• Serve as the point of contact for Medicaid audits

Skills and Competencies:

• ABA billing experience with Central Reach experience required for remote work.
• Associate Degree in Accounting/Finance Management is plus, but not required.
• Strong communication and presentation skills.
• Previous patient admission or verification experience required.
• Confident communication skills for fielding calls on behalf of the agency and its representatives.
• Excellent written communication skills for professional emails and various reporting methods.

Personality: A successful Team Member will be…

• Detail-oriented & highly organized
• Communicative & collaborative
• Committed to purposeful care
• Ambition to grow with the company