The Billing Specialist is responsible for the accurate and timely processing of claims, maintaining accounts receivable for assigned payers, and escalating ongoing issues to the Billing Manager. This role works closely with payers, clients, and internal revenue cycle staff to resolve billing discrepancies and denials.
Key responsibilities include:
- Managing payer and patient accounts receivable
- Working correction tickets for billings before or after payment has been received
- Submitting claims electronically through Availity Revenue Cycle Management and other clearinghouses
- Submitting secondary claims and preparing and mailing paper claims
- Correcting claims that have been scrubbed for errors before submission
- Working claim denials through CareLogic
- Calling payers to appeal denials and collaborating with payer representatives to resolve erroneous denials
- Answering client questions regarding account balances
- Performing data entry and other duties as assigned by the Revenue Cycle Manager or Billing Supervisor
Requirements & Qualifications
The ideal candidate will have:
- High school diploma or equivalent
- 1 to 2 years of experience in claims and billing preferred
- Billing or administrative experience in developmental disabilities and/or behavioral health, mental health, or substance use preferred
- Proficiency with Microsoft Office and Excel
- Experience with Availity and KY Medicaid software helpful
- Comprehensive knowledge of ICD-10, CPT, and HCPCS coding
- Strong oral and written communication skills
- Ability to multitask and work efficiently in a fast-paced environment
- Ability to work collaboratively in a group setting
- Must pass a legally required Criminal Record Check and Sexual Offender Registry check
Location
Kentucky, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
4 weeks ago
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