GENERAL SUMMARY AND SCOPE
Under the supervision of the BH Lead Billing Specialist and Financial Systems Director, prepares and submits bills to proper payers according to payor requirements; reviews patient accounts and ensures their accuracy and completeness; verifies insurance coverage with insurance companies; processes statements; monitors outstanding accounts; processes refunds for overpaid accounts; receives and answers billing-related inquiries with patience and respect; and prepares billing reports.
ESSENTIAL TASKS, DUTIES, AND RESPONSIBILITIES
Determines and sets up payor for agency client in the Behavioral Health Information System (CATT). Processes electronic billing files for all third party payers, including Board, Title XX, Medicaid and insurance companies. Manages denial/error and open charge reports.
Adjusts patient accounts based on payments from insurance and Board and sends bills to client for any balances due.
Monitors Accounts Receivable Aging Analysis. Utilizes information to write off differences on accounts that are Board paid and followsup in a timely manner with third party payers and clients for their portions. Moves client balances to collections as needed.
Communicates the need to staff to obtain insurance pre-authorizations.
Creates and submits Ohio Behavioral Health Data files, clears error reports.
Has great communication skills to relate to internal and external customers in a professional way. Takes calls and answers financial questions from clients and third parties regarding bills with respect and patience.
Assists in preparation for audits and prepares by Mental Health and Recovery Board. Alerts Management any other irregularity regarding Behavioral Health billing.
Prepares reports for the Boards (TXX, Forensics, Indigent Driver). Processes case openings to ensure prompt billing services.
Posts payments from cash receipts, checks and ERA's in a timely manner.
KNOWLEDGE SKILLS AND ABILITIES
High School graduate, or equivalent.
Have 3 years medical billing experience and knowledge of payor sources.
Knowledge of Behavioral Health billing, preferred.
Ability to read and write in small letters and numbers and perform complex arithmetic and financial applications.
Good computer aptitude. Proficient in excel and word.
Punctual attendance at assigned work location is required.
Ability to understand instructions and communication effectively, in both oral and written form.
Ability to work in fast paced, deadline oriented department with exceptional organizational and analytical skills.
Ability to work in a safe and efficient manner and maintain an accident free work place, including ability to demonstrate a working knowledge of emergency codes.
Ability to comply with OSHA regulations and CDC standard and transmission-based recommendations and to utilize proper personal protective equipment. Ability to comply with provisions of applicable S.D.S. forms.
Successful completion of a ninety (90) day probationary period.
Firelands Regional Medical Center