Billing Specialist

POSITION SUMMARY

As a Billing Specialist at Mind Body Optimization, you will play a crucial role in ensuring accurate and timely billing processes for healthcare services provided at our facilities. Your primary responsibility will be to manage the billing cycle, from capturing patient information to submitting claims and following up on reimbursements. Your attention to detail, knowledge of medical coding and billing regulations, and effective communication skills will contribute to the financial success of the healthcare organization.

QUALIFICATIONS

Education: Bachelor’s Degree from an accredited college or university in Healthcare Administration, Business Administration or relevant field of study preferred. High school diploma or GED required.

Experience: Previous experience in an outpatient healthcare setting preferred.

Additional Requirements: Familiarity with insurance verification and pre-authorization processes. Proficiency in using billing software and electronic medical records (EMRs). Understanding of healthcare compliance regulations and reimbursement policies.

PRIMARY RESPONSIBILITIES

Patient Information and Data Entry:

• Accurately capture and enter patient demographic and insurance information into the billing system.
• Verify insurance coverage, eligibility, and obtain any required pre-authorization for services.

Medical Coding:

• Assign appropriate CPT, HCPCS, and ICD-10 codes to ensure accurate representation of the services provided.
• Stay updated on coding changes and compliance requirements.

Claim Preparation and Submission:

• Compile and prepare claims for submission to insurance carriers, government programs, or other third-party payers.
• Ensure claims are submitted in a timely manner, meeting all regulatory deadlines.

Payment Posting and Reconciliation:

• Record and reconcile payments received from insurance companies, patients, and other sources.
• Investigate and resolve any discrepancies in payments.

Denial Management:

• Analyze and address claim denials promptly, identifying and correcting errors or missing information.
• Appeal denied claims when necessary, providing supporting documentation.

Follow-up on Unpaid Claims:

• Monitor and track unpaid claims, initiating follow-up activities with insurance carriers to ensure timely reimbursement.
• Communicate with insurance companies to resolve outstanding issues and expedite the payment process.

Patient Communication:

• Respond to patient inquiries regarding billing statements, insurance coverage, and payment options.
• Assist patients with understanding their financial responsibility and setting up payment plans if needed.

Compliance and Regulations:

• Stay informed about healthcare billing regulations, compliance requirements, and changes in reimbursement policies.
• Ensure that billing practices adhere to all relevant laws and guidelines.

Reporting:

• Generate and analyze billing reports to assess the financial performance of the outpatient services.
• Provide regular updates to management on key performance indicators and areas for improvement.

Collaboration:

• Work closely with other healthcare professionals, including clinicians, administrative staff, and finance teams, to streamline billing processes and resolve issues efficiently.

Note: The essential job functions of this position are not limited to the duties listed above.