Billing Specialist

Role Overview

• Ensure strict HIPAA-compliant confidentiality with all client data and claims
• Manage and operate in multiple different billing platforms dependent on client needs which could include Azalea, Tebra, Central Reach and/or Rethink Integrated Billing Module
• Manage assigned client accounts billing scrubs for primary and secondary claims
• Submit claims electronically for primary and secondary payors
• Solve clearinghouse rejections
• Submit corrected claims for billing errors, rebill projects (new plans/new year, new information on payor policies)
• Maintain account spreadsheets, billing cheat sheets, provider, and billing information including provider roster and payer policy billing rules
• Contribute to updates and communicate to Customer Billing Advocate and other members of POD
• Provide internal reporting to team of status and issues for clients within POD
• Meet internal benchmarks for clean claims / first pass rate, unbilled claims, clearinghouse rejections, secondary claims, and denials for billing errors
• Research specific payor billing rules as needed
• Review client billing documentation to ensure claims are submitted based on payor requirements
• Stay informed about Payor and Industry Billing rules
• Foster a positive work environment for team members

Requirements

• 1-2 years of billing experience in speech, occupational, and ABA therapy.
• Strong knowledge of CPT coding and billing rules for major health insurance companies
• Experience working directly with large insurance companies such as Blue Cross Blue Shield, Cigna, Magellan, etc.
• Proficiently using Billing Software and Clearinghouse systems (Azalea, Kareo, Waystar, TriZetto, Azalea, Central Reach).
• Proficient using Microsoft Suite (Outlook, Excel, Word).

Benefits

• PTO and Vacation Days after a 90-day introductory period
• Paid Holidays
• Generous Health, Denial & Vision benefits package
• 401k + Matching