Reimbursement Specialist - Healthcare determines the extent to which patients' insurance covers their treatments. Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted. Being a Reimbursement Specialist - Healthcare ensures compliance with Federal and State regulations and company policies that govern Medicare and state payment systems. May assist in identifying fraudulent non-plan billing practices and assists the legal department with litigation preparation. Additionally, Reimbursement Specialist - Healthcare may require a bachelor's degree. Typically reports to a supervisor or manager. Typically requires Certified Professional Coder (CPC) from AAPC or AHIMA. The Reimbursement Specialist - Healthcare gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Reimbursement Specialist - Healthcare typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Dynamic Youth Community, Inc. is seeking a Full-time Billing Specialist. This individual will be responsible for the creation of claims, tracking of eligibility, and follow-up of all denials for the facility.
The annual salary range is $50,000-52,000, with a competitive benefits package. If you are interested in the vacancy, submit your cover letter along with your resume to administration@dycinc.org
Your application will ONLY be accepted via email.
Description:
The Full-time Behavioral Healthcare Biller:
· Assists in the preparation and submission of claims for behavioral health services, ensuring compliance with both healthcare policies and billing codes.
· Diligently follows up on denied claims, investigating the cause of the denial, rectifying any errors and resubmitting the claim as necessary.
· Performs regular eligibility checks for patients, verifying insurance coverage and informing the appropriate parties of any changes or issues.
· Maintains accurate and updated patient billing records, ensuring confidentiality and adherence to HIPAA and 42 CFR Part 2 Regulations.
· Provides support to the department in the resolution of billing discrepancies and issues.
· Collaborates with healthcare providers and staff to ensure accurate and timely billing of services is provided.
· Assists in the preparation of reports detailing billing activities, denials and resolution efforts.
· Utilizes billing software efficiently and keeps up to date with changes in insurance regulations and billing practices.
· Coordinates with contracted payers to ensure compliance, and negotiates updates to contracts in conjunction with agency management.
· Completes additional billing-related tasks as requested by supervisor.
Standard Criteria:
· Interacting with staff, clients and visitors in a courteous, professional and respectful manner that is consistent with the agency’s missions and values.
· Producing accurate, neat and thorough work.
· Prioritizing and planning work efficiently; effectively managing competing demands and dealing with changes, delays, as well as unexpected events.
· Understanding and consistently complying with agency policy and procedures (including time and attendance, dress code, etc.)
· Supporting a positive work atmosphere by behaving and communicating in a manner that allows the employee to get along with clients, coworkers and supervisors.
· Communicating (in writing & orally), clearly and concisely.
· Illustrating flexibility and adaptability in role and function when circumstances warrant; (demonstrates openness to assist in needed responsibilities in evolving situations).
· Maintaning appropriate boundaries, ethics and professionalism; complying with agency, OASAS and other professional code(s) of ethics; seeking supervision when challenges arise.
Qualifications
Position Status
This is a full time, in-person position.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Must have the ability to travel among assigned sites as needed. There may be long periods of standing, sitting, and computer usage.
Job Type: Full-time
Pay: $50,000.00 - $52,000.00 per year
Benefits:
Schedule:
Work setting:
Work Location: In person
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