Billing Specialist

SUMMARY

The Revenue & Billing Coordinator at CLEARFORK ACADEMY is responsible for the design, implementation, and execution of the

entire billing process beginning with verification of benefits and ending with payment collection and claim close out. The Revenue & Billing Coordinator generates revenue for Clearfork Academy by making payment arrangements. This is accomplished through collecting accounts, monitoring, and pursuing delinquent accounts as well as completing claim follow up and dispute resolution with insurance companies on both an in-network and out of network basis, as well as with private pay clients. This position requires the ability to produce and present financial billing reports at regular intervals.

• Confirms eligibility and benefits verifications for treatment at all facilities.
• Inputsthe correct billing codes for services rendered and usesthose codes to bill insurance providers.
• Preparing, reviewing, and transmitting claims using electronic billing software.
• Identifies and billssecondary and tertiary insurancesfor eligible clients.
• Follows up on unpaid claims within standard 60-day billing cycle timeframe.
• Analyzes Explanation of Benefits (EOB) forms to ensure insurance companies have paid correctly for billed charges.
• Review client bills for accuracy and completeness and obtaining any missing information.
• Callsinsurance companies regarding any discrepancy in payments if necessary.
• Research and appeal denied claims.
• Collects delinquent accounts by establishing payment arrangements with clients; monitoring payments; following up with clients when payment lapses occur.
• Utilizes collection agencies and small claims court to collect accounts by evaluating and selecting collection agencies; determining appropriateness of pursuing legal remedies; testifying for the facility in court cases.
• Reviews accounts for insurance or patient follow-up.
• Answers all client or insurance telephone inquiries pertaining to assigned accounts.
• Updates billing software with rate changes.
• Updates cash spreadsheets, running collection reports, and providing month end reporting of billing department information including KPIs.
• Develop and implement quality assurance for all billing and collection core processes for special program and implementation for all levels of care provided under the Clearfork Academy umbrella of services.
• Audits charts and accounts for financials, correct insurance policy information, financial agreements, invoices, etc.
• Coordinate with all other departments to assure that billing is being reported in an accurate and timely fashion.
• Personnel development through the hosting of L10 department staff meetings.
• Submits contracts for credentialing, with follow ups.
• Createssingle case agreements with providers for specifics plansthat do not have out of network benefits.
• Update all payers quarterly with required information to stay enrolled in EFT’s, claim status and any other communications
• Other duties and tasks as assigned.

Requirements

MINIMUM JOB REQUIREMENTS

Education, Training, and Experience Required:

• Bachelor’s Degree in related field of study (preferred)
• 2 to 5 years work experience as a Billing Specialist, preferably in the field of chemical dependency and/or behavioral health.
• Current CPR/FA certification
• Current Handle with Care Physical Holding Certification