Summary The Medical Billing Specialist is primarily responsible for completing resident billing, basic accounting, customer service, and organizational tasks to promote the financial health of the organization. This position also handles cash items, accounts receivable postings, and assists with grant applications. The Medical Billing Specialist works under the direction of the Finance Manager and leads through the principles of high reliability to support the mission and a culture of safety.

Job Responsibilities/Essential Functions:

Performs clerical and accounting functions for resident billing, including verification of invoice information, maintenance of third-party billing records, and resolution of problems. Follows up on submitted claims and patient billing; resubmits claims or corrects inaccuracies. Calculates service charges for all departments/programs. Submits claims, posts charges, payments, and write-offs into the Accounts Receivable database. Verifies accuracy of billing data and codes; identifies errors and makes corrections as needed. Collaborates with department directors to obtain missing information, information to prepare and submit all prior authorizations to insurance companies. Processes incoming payments from insurance companies and customers. Follows up on aging claims and overdue balances. Establishes budget payment plans as needed. Sends collections letters and prepares information for collection agencies as necessary. Researches and resolves billing issues; answers questions; responds to complaints. Maintains timely and accurate documentation processes. Complete provider credentialing paperwork and other requests from insurance carriers. Creates and organizes files for resident data and internal records. Collects billing information needed for BRS (Behavioral Rehabilitation Services) Cost Report annually; supports Finance Manager annual analysis of fees for service. Assists Executive Director with preparation and submission of grant applications, maintains accurate record of past and present grants. Provides administrative support including but not limited to, maintaining accounting and contract files, tracking contract due dates, etc. Other duties as assigned. Skills and Abilities Operational; ability to adhere to the role's professional standards of practice and provide services consistent with the mission. Regulatory; knowledge of state and federal healthcare regulations pertaining to home health care, specifically pediatric group homes, and adult family homes. Leadership; fosters a collaborative, team-oriented environment by modeling respect and core values, high reliability, open communication, and positive daily interaction. Ability to apply conflict resolution strategies as needed. Independent Judgment; ability to independently manage programs and delivery of services. High degree of initiative, creativity, and accountability in decision making. Problem solving and data analytical skills; ability to assess, think critically, and formulate solutions based on data and observation. Able to collect and complete data analysis. Savvy with technology. Financial Literacy; ability to make informed and effective decisions with financial resources. Savvy with budget and financials; participates in financial planning to ensure facility operates within allocated funds and cost-effective way. Communication and interpersonal skills; ability to communicate effectively in order to understand concerns, assess conditions, and instruct others. Ability to read, write, and speak English clearly. Ability to work collaboratively with parents/guardians, caregivers, and multi-disciplinary team. Emotional Stability; patience and calm demeanor. Ability to manage emotions and demonstrate leadership at all times, during emergencies and other stressful situations. Resilient. Confidentiality; adherence to organization's policies, procedures, infection prevention, safety, confidentiality policies and procedures; HIPAA and all state and federal medical privacy laws. Cultural Competency; ability to demonstrate sensitivity and respect to community members from multiple cultures, and to individuals who experience disabilities. Required Qualifications High school diploma or equivalent At least 1 year experience in medical billing Experience with Medical Terminology and Coding Experience in completing grant applications or course in grant writing Proficiency in QuickBooks and MS 365 Office Suite Strong attention to detail and accuracy Healthcare Provider BLS/CPR within 60 days of hire Food Handler's Card within 60 days of hire Must pass a State and Federal Background Check, including fingerprints Valid State Driver's License Proof of licensing required vaccinations Behavior Management Training within 60 days of hire Abuse Prevention Systems Sexual Abuse Awareness Training within 90 days of hire Work Environment This position is inclusive of all resident care programs of Pope's Place.

The position requires flexibility as hours of work are subject to operational needs. The environment may include exposure to communicable diseases, bodily fluids, and other potential hazards. Must wear Personal Protective Equipment (PPE) as required and follow strict guidelines to protect self and residents from infectious disease.

Pay:

$20.92 - $34.41 per hour

Benefits:

Dental insurance Employee assistance program Flexible schedule Health insurance Paid time off Tuition reimbursement Vision insurance

Work Location:

In person