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    Full-Time Billing Specialist - Lancaster, United States - Swank Early Skills Development

    Swank Early Skills Development
    Swank Early Skills Development Lancaster, United States

    3 weeks ago

    Default job background
    Full time
    Description

    Swank Early Skills Development is seeking an experienced Billing Specialist to join our team at our Lancaster, PA Center

    Seeking a professional with at least 1 year experience working in the medical billing profession. Experience in medical billing for Behavioral Health or Applied Behavior Analysis (ABA) for commercial insurance and Medical Assistance (MA) are not required but helpful.

    Compensation:

    • Competitive hourly pay rate $19-$21 depending on training and experience
    • Paid Time Off- accrual based
    • 10 paid holidays annually (9 company holidays and 1 floating holiday)
    • Performance-based raise opportunities
    • Intermittent bonuses
    • Informal Profit-Sharing
    • Company incentive program
    • Company referral bonuses
    Benefits:
    • Medical Insurance - with a percentage employer premium contribution towards employee premium
    • Dental Insurance
    • Vision Insurance
    • Life Insurance*
    • Short Term and Long Term Disability*
    • Simple IRA Retirement Plan with Company match- for qualified employees who enroll
    *designates a company-paid benefit

    Essential Functions and Responsibilities:
    • Submit insurance claims (primary, secondary and tertiary) across appropriate funder portals at least weekly and within required "timely filing" guidelines to ensure consistent revenue cycle
    • Monitor claim denials, resolutions and resubmissions
    • Monitor outstanding claims balances and outstanding revenue
    • Create, send and follow up on invoices in order to collect financial obligation of the client
    • Obtain, maintain, and distribute information about prior authorization for client services to clients, clinicians and operations team members
    • Enter authorizations in designated client tracking system
    • Provide support to the greater operations and clinical team members with authorization updates, claims status reports and outstanding revenue reports
    • Process initial benefits verifications and communicate with families regarding findings
    • Monitoring client active benefits through EVS checks
    • Assist families with coordination of benefits
    • Maintain information on claims processing procedures and step by step guidelines for claims monitoring for all funders
    • Secure SESD's ability to do business with Private Health Insurance companies and Medical Assistance
    • Monitor claims payments and ensure that rates paid align with funder fee schedules
    • Works independently to ensure streamline processes and ensure
    Other Required Skills and Abilities:
    • Works collaboratively with other members of the Operations Team to ensure cohesive and efficient processes and outcomes.
    • Uses strong problem-solving skills and takes initiative to provide solutions for barriers to providing services to our clients.
    • Multi-tasks and shifts easily between various tasks as needed, following up on unfinished projects in a timely manner
    • Handles sensitive company documents and information with the utmost privacy and security as per company procedures, following both HIPAA and FERPA regulations as they apply.
    • Demonstrates the ability to effectively and efficiently use Microsoft Office Word, Excel, and other Office Products in the engagement of data collection, tracking, report writing, and other activities that are needed in this role.
    • Demonstrates the ability to quickly learn and begin to use other software required for the execution of business in the company as it arises.
    • Demonstrates the ability to effectively and efficiently manage documentation systems related to contract fulfillment, contract compliance, invoicing, and payment processing.
    • Demonstrates excellent verbal and written communication skills: the ability to communicate professionally, and positively with coworkers, clients, and contacts that the company receives from the outside.
    • Effectively communicates with potential clients, clients, business associates, and co-workers with positivity and compassion through all means of communication.
    • Handles challenging conversations with clients and insurance providers with positive firmness and respect.
    • Effectively decides when situations need to be elevated to ACOM, COM or other members of management depending on nature of concerns or situation.
    Physical Demands of Role
    • Using a physical key to unlock and lock Company doors, filing cabinets, and other locked
    • storage facilities or devices.
    • Looking at a computer / electronic device screen for most of the workday.
    • Typing / keyboarding for most of the workday.
    • Sitting at a computer for most of the workday.
    • Vocally communicating with people frequently throughout the workday.
    Minimum Qualifications
    • High School Diploma/GED required (College Degree preferred)
    • At least one(1) year of continuous and proven experience as a medical billing specialist, preferably in a Behavioral Health environment
    • Strong mathematics skills and a good command of the English language
    • Ability to process financial information quickly and accurately
    • Strong knowledge of health insurance providers, including medical assistance
    • 3 positive professional reference checks, including one from former/current direct supervisor
    • Can produce "clear" PA required clearances (PA Child Abuse Clearance, PA State Criminal Check, FBI Fingerprint Clearance) valid within 1 year of hire date
    • TB Test
    • Mandated Reporter training
    • Proof of Eligibility to work in the U.S.
    Other Preferred Qualifications (not required) which will be considered in the starting hourly rate offer:
    • Certified in Billing and Coding
    • College degree or further education in the skills required for the role
    • Experience in Behavioral Health or Applied Behavior Analysis (ABA) billing and authorizations
    Come Join Our Team

    Swank Early Skills Development LLC is an Equal Employment Opportunity/Affirmative Action Employer and does not discriminate on the basis of race/color, religion, sex, sexual orientation, gender identity, national origin, medical history, protected veteran status, disability or any other legally protected status.
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