Job Description

COME JOIN OUR AMAZING TEAM AS A BILLING SPECIALIST!

Come join our AMAZING team!

STAR of CA is seeking for a motivated Billing Specialist who is interested in helping us to grow and carry out our mission of service to individuals with autism spectrum disorders and their families. The Billing Specialist is responsible for the timely submission of technical or professional medical claims to insurance companies for ABA service.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Reviews patient bills for accuracy and completeness; obtains missing information.
• Knowledge of insurance, especially Medicare and Medicaid, rules and guidelines.
• Identify insurance company or proper party (patient) to be billed; identify and bill secondary or tertiary insurances.
• Utilize a combination of electronic health record (EHR) and paper patient records to perform billing duties; maintain an accurate, legally compliant medical record.
• Process claims as they are paid and credit accounts accordingly.
• Review insurance payments for accuracy and compliance with contract discounts.
• Review denials or partially paid claims and work with the involved parties to resolve the discrepancy.
• Manage assigned accounts ensuring outstanding/pending claims are paid in a timely manner and contact appropriate parties to collect payment.
• Communicate with health care providers, patients, insurance claim representatives and other parties to clarify billing issues and facilitate timely payment.
• Consult supervisor, team members and appropriate resources to solve billing and collection questions and issues.
• Maintain work operations and quality by following standards, policies and procedures; escalate compliance issues to supervisor.
• Prepare reports and forms as directed and in accordance with established policies.
• Perform a variety of administrative duties including but not limited to: answering phones; faxing and filing of confidential documents; and basic Internet and email utilization.
• Provide excellent and professional customer service to internal and external customers.
• Function as contributing team member while meeting deadlines and productivity standards.

QUALIFICATIONS:

• High School Diploma required
• Medical billing experience required
• Excellent customer service skills
• Ability to maintain a high level of confidentiality for patient protected health information in accordance with legal requirements and company policy
• Strong critical-thinking skills
• Excellent verbal communication and written communication skills
• Excellent follow-through and time-management skills