Boise, Idaho
Medical Billing/Coding Specialist Job Opening in Boise, Idaho - Summary of duties: Responsible for the timely submission of claims and follow up with Insurance companies to ensure accurate reimbursements. This involves collecting billing data, posting claims and managing account payments. Responsible for entering and coding patient services into a computer system and generating invoices to be sent to the patient. Sorts and files paperwork, handles insurance claims, and performs collections duties.
Essential job functions:
Billing
Verify patient coverage and demographic information draw conclusions and correct billing errors or other claim issues.
Evaluate patient?s financial status and establish budget payment plans
Prepare and submit clean claims to insurance companies through the appropriate means i.e. electronically or by paper utilizing component based billing under ICD-10
Identify and bill secondary or tertiary insurance and submit monthly statements to patients as needed
Review patient bills for accuracy, completeness and reconcile patient accounts
Audit accounts for refunds and unapplied payments. Follow up on unpaid/Aging claims within standard billing cycle timeframe
Process payments and EOBs; review EOBs for denials, rejections and appeals
Track claims through the billing process and identify problem areas; troubleshoot & resolve billing issues by calling insurance companies regarding any discrepancy in payments if necessary
Follow and report status of delinquent accounts and Prepares information for the collection agency as appropriate.
Verify services provided and submit invoices to contracting agencies
Address inquiries made by patients, contractors, and insurance companies
Identify and resolve patient billing complaints.
Communicates and works collaboratively with all department managers, staff, contractors, clients/family members (as needed) while maintaining strictest confidentiality; adheres to all HIPAA
Collaborate with Office and Clinic Managers as well as other agency contractors to resolve problems related to billing, claims and reimbursement.
Record Keeping
Translate patient information into alphanumeric medical code.
Collect, post, and manage patient account payments.
Review delinquent accounts
Process payments from insurance companies.
Sort/file paperwork, maintain accurate reports
Ethics
Conducts self in accordance with TSWSC employee manual
Maintains strictest confidentiality, adheres to all HIPAA
Follow the professional billing specialists code of ethics.
Administrative
Manage the agency?s Accounts Receivable reports
Updates job knowledge by participating in educational opportunities.
Attend meetings and participate in Budget development as required.
Desired Skills/ Experience:
Must have MEDICAID billing & claims experience and knowledge of all Commercial Insurance guidelines.
Ability to read, understand and follow oral and written instructions.
Ability to establish and maintain effective working relationships with patients,
employees and the public.
Must be well organized and detail-oriented.
Knowledge of medical billing/collection practices.
Education:
Medical Billing/Coding certification. Knowledge of business and accounting processes usually obtained from an Associate in Business Administration, Accounting or Health Care Administration preferred.
Must have the required licenses and certifications to practice in the State of Idaho
College degree or equivalent in direct experience
2+ years of related experience in Mental healthcare environment.
Customer Service focused with knowledge of systems, methods and processes that support excellence in service.
Physical Demands:
Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a calculator and computer keyboard.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, skills and working conditions may change as needs evolve.
Job Type: Part-time
Required education:
Associate
Required experience:
Medical Billing: 1 year
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