Leave Specialist jobs in Pierre, SD

Billing Specialist

Location: Pierre, SD

Agency: Capital Area Counseling Service Inc.

Employment Category: Hourly

Employment Type: Full-time

Starting wage $21.06/hour

Closing Date: 11/30/2024

Duties/Responsibilities:

A/R Billing:

Responsible for establishing and maintaining Programs and Procedure Codes, Coverage Plans and all other internal codes on Streamline.

Perform behavioral health claim billing via electronic and manual submission.

Manages internal processes for the EHR billing cycle, including but not limited to:

Billing processes for private insurance, state insurance, and private pay services.

This includes preparing and uploading electronic claim files, following up with additional documentation if requested, and preparing all client statements.

Oversight of aging AR to ensure timely reimbursement, which includes:

Utilizing reports to follow up on unpaid claims in a timely manner.

Reading and interpreting explanation of benefits (EOBs)

Tracking claim payments and resolve rejected claim issues by re-submitting claims or contacting appropriate insurance companies or the state when applicable

Accurate medical codes are established in the system.

Ensuring charges comply with regulations.

Trouble shoots billing error issues and provides guidance to the appropriate party for correcting the error.

Prepares additional billing invoices that align with services rendered.

Applies all payments on the EHR and monitors, follows up, and tracks all unpaid services.

Draft effective appeals to insurance companies or state resources.

Willingness to cross train as needed

Other billing related tasks as needed

Finance Accounting Controls:

Assists the finance team with internal accounting controls for CACS, including but limited to:

Ensuring the accounts receivables are properly recorded in the accounting system.

Performing the monthly bank reconciliation in the accounting system.

Bringing any AR issues and possible solutions to the team to ensure maximum revenues.

Maintains a knowledge of the general ledger mapping in the EHR, updates mapping as new programs and procedures are implemented, and follows payments and adjustments through the general ledger process to ensure proper accounting of revenues.

Required Skills/ Abilities

Maintain working knowledge of state and federal billing guidelines that relate to private insurance, Medicaid, and other payer sources’ rules and regulations regarding reimbursement.

Knowledge of medical coding and billing language preferred.

Currently certified or the ability to obtain certification from the American Academy of Professional Coders (AAPC) within 6 months.

Strong background in accounts receivable in a medical setting.

Strong verbal and written communication skills

Understanding of accounting rules and regulations.

Ability to act independently, with good judgment

Ability to work effectively as part of a team

Strong organizational skills

Ability to clearly set expectations

Ability to maintain confidentiality

Knowledge of rules and regulations pertaining to mental health /addiction services and programs

Ability to plan, coordinate, prioritize work

Maintain confidentiality and comply with agency compliance plan and code of ethics

Excellent computer skills/proficient in computer applications, specifically MS Office, word processing, spreadsheets, data entry and internet

Problem solving skills

Ability to meet deadlines

Valid Driver’s License

Education and Experience:

An Associate degree in finance, accounting, or health information or equivalent years of experience.

Previous experience in medical reimbursement or medical billing service.

Physical Requirements:

Prolonged periods sitting at a desk and working on a computer.

Must be able to lift up to 15 pounds at times.