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    Billing Specialist - Columbus, United States - ST VINCENT FAMILY SERVICES

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    Description

    Job Description

    Job Description

    SUMMARY

    This Billing Specialist position is responsible for correcting, completing, and processing service claims for all payer types. He / She is also required to generate reports from both the billing system and the clearinghouse system in accordance with established procedures. This person has public contact of a limited scope, involving routine and standard information exchange with payers, the clearinghouse, client responsible parties and other employees when necessary. This person reports to the Billing Manager.

    GENERAL RESPONSIBILITIES

    • Contributes to creating a welcoming and inclusive environment for our clients, colleagues and community partners from diverse backgrounds and experiences.
    • Integrates principles of Trauma Informed Care in all aspects of work.
    • Is sensitive to the children's culture and socioeconomic characteristics that delivers the best possible care to the youth and families served.

    MEDICAL BILLING

    • Weekly review of all validation reports before claim submission.
    • Send electronic billing file(s) for all claim payers on weekly basis or other time frame as established by the Finance Team.
    • Weekly rework claim errors on all payers in order to expedite payment of the erroneous claims.
    • Enroll new and returning clients with local board(s) to gain access to public funding for service payment.
    • Upload electronic payment files, reviewing and working unpaid claims.
    • Enter cash receipts and assure correct allocations and distributions in accordance with the established protocol.
    • Adhere to monthly closing schedules set by the Finance team.
    • Identify unbilled claims (on a weekly basis) and expedite the billing to avoid non-payment due to untimely filing (know the payer limitations.
    • Locate missing Explanation of Benefits (EOB's) for commercial insurance to appropriately move balances to the next payer.
    • Rebill or re-adjudicate unpaid claims in all payer systems.
    • Download / upload appropriate payer reports.
    • Work with staff to enroll in payer networks.
    • Other duties as assigned or requested.

    EDUCATION BILLING

    • Facilitates the enrollment of families in non-public school educational funding programs.

    EDUCATION & EXPERIENCE

    • High School diploma or equivalent is required.
    • Minimum of 3-years billing experience is required.

    TECHNICAL SKILLS

    • Strong computer skills to include proficiency with Microsoft Office Suite (i.e. MS Word, Excel and Access).
    • The ability to research and analyze various different types of data information.
    • Ability to use standard office equipment such as copy/fax machines and printers.

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