Provides Insurance Billing and Coding support for the Genetworx Lab billing team. Responsible for inputting data into multiple systems related to client information, insurance information, attendance and coding for services rendered. Coordinates with billing team to immediately resolve billing inconsistencies and delinquent data and support overall revenue cycle management. Responsible for verification of benefits, billing data, claims submission, claim corrections, claim re-submissions, claim follow up and appeals. Navigate insurance payer phone trees and obtain valid information. Generates revenue by making payment arrangements; collecting accounts; monitoring and pursuing delinquent accounts. Presents ideas and collaborates with billing team about billing practices and methods to increase revenue.
- Contribute to a high-performing culture
- Adhere to all aspects of the program’s policies and procedures to ensure quality performance and assist the billing team in any quality improvements that may be necessary
- Complete initial verification of benefits in order to provide cost estimates for client out of pocket expenses
- Participate in weekly team meetings discussing billing department goals and progress
- Assist in the recruitment of additional team members with Mental Health / Substance Abuse billing & coding experience
- Record attendance in billing software for services performed in order to submit claims
- Complete necessary documentation, timely entries into the records, and maintain compliance with overall documentation
- Process insurance claims for private and employer insurance reimbursement
- Work with clients, families, billing and admissions team to develop self-pay arrangements and payment plans
- Process and follow up on payer denials, consulting with the client and/or his or her family as needed
- Post payments in a timely manner
- Reconcile payments in billing software to bank statements
- Initiate private pay collections after insurance cancellation, denial or other issue
- Must have valid driver’s license
- Work closely with all members of treatment team to assure positive working relationships
- Must consistently demonstrate the ability to establish and maintain good public relations with families, referral agencies, and other community resources
- Must have the ability to express ideas clearly, concisely, convincingly, and effectively when addressing an audience
- To consistently exercise good judgment and adequate emotional stability in evaluating situations and making decisions despite the pressures of deadlines or the occurrence of unexpected stressful events
- Other duties as assigned
Education and Experience:
- Advanced skills in MS Word, PowerPoint, Outlook, and Excel.
- 2+ years of Lab Billing and Coding practices experience required.
- Requires knowledge and understanding of Out of Network insurance claims and appeals process.
- Knowledge of mental health/substance use disorder coding and billing preferred.
- High school diploma/GED required, prefer Bachelors Degree.
- Coding certificate or associates degree in business administration or health care administration preferred
Customer Service: Demonstrates concern for meeting internal and external customers’ needs in a manger that provides satisfaction for the customer within the resources that can be made available.
Impact and Influence: Works effectively with and through others including those whom there is no formal authority over.
Project Management: Coordinates the diverse components of the project by balancing scope, time, cost, and quality.
Communication: Communicates well both verbally and in writing, creates accurate and punctual reports, delivers presentations, shares information and ideas with others, has good listening skills.
Work Environment: May work in a variety of environments including professional offices, clinics,hospitals, or out-patient facilities. They spend much of their time on their feet, actively working with patients.
Physical Demands: While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands to finger, handle or feel objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move objects up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus.
Travel: Travel is primarily local during the business day, although some out-of-the-area and overnight travel may be expected.