Insurance Billing Associate
Outreach Recovery, United States
Job Description
Outreach Recovery is a national leader in the treatment of substance use disorders. With over 20 facilities in the Mid-Atlantic region and growing, we are looking to continue our growth and bring on expert and dedicated team members to reach a population in desperate need. We are currently looking for a Insurance Billing Specialist to join our Mental Health team.
General Duties and Responsibilties:
• Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Insures claim information is complete and accurate.
• Submits insurance claims to a clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
• Answer patient questions on patient responsible portions, copays, deductibles, write-offs, etc. Resolves patient complaints or explains why certain services are not covered.
• Follows up with insurance company on unpaid or rejected claims. Resolves issues and re-submits claims.
• Prepares appeal letters to insurance carriers when not in agreement with claim denials. Collect necessary information to accompany appeals.
• Prepares patient statements for charges not covered by insurance. Insures statements are mailed on a regular basis.
• May work with patients to establish a payment plan for past due accounts in accordance with provider policies.
• Provides necessary information to collection agencies for delinquent or past due accounts.
• Post insurance and patient payments using medical claim billing software.
• May perform soft collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
• For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by the primary insurer.
• Follows HIPAA guidelines in handling patient information.
• May periodically create insurance or patient aging reports using the medical practice billing software. These reports are used to identify unpaid insurance claims or patient accounts.
• Understands managed care authorizations and limits to coverage such as the number of visits. This is encountered often when billing for specialties.
• May have to verify patient benefits eligibility and coverage.
• Ability to look up ICD 10 diagnosis and CPT treatment codes from online service or using traditional coding references.
Requirements
1. Behavioral Health/ Primary Care billing experience and familiar with Optum Medicaid and MD Physician's Care.
2. High-level in using Excel and Microsoft suite.
3. Problem-solver, assertive and attentiion to detail.
4. Experience with Optum authorization, cash posting, and follow-up aging report.
5. Ability to handle high claim volume and good organizational skills.
6. New Jersey Billing and/or out-of state billing a plus, but not required.
7. Coding certification a plus, but not required
8. High degree of attention to detail and trustworthiness
9. Proven experience as Billing Specialist
10. Comfortable dealing with numbers and the processing of financial information
Benefits
- Health Care Plan (Medical, Dental amp; Vision)
- Paid Time Off (Vacation, Sick amp; Holidays)
- Life Insurance
- 401K plan