Job Title: Billing Specialist
Department: Billing
Supervisor: Billing Manager
Work Location: Headquarters
Schedule: Monday-Friday 8:30 a.m.-5:30 p.m. (Schedule may change according to Business needs.)
JOB DESCRIPTION
To perform this job successfully, an individual must be able to perform the essential job functions satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the primary job functions described herein. Since every duty associated with this position may not be described herein, employees may be required to perform duties not specifically spelled out in the job description, but which may be reasonably considered to be incidental in the performing of their duties just as though they were actually written out in this job description.
ESSENTIAL JOB FUNCTIONS
The Billing Specialist is tasked with planning, directing, leading and coordinating with the team to execute efficient, timely, accurate claims submissions as well as to audit, resubmit, and reconcile claims.
DUTIES & RESPONSIBILITIES
- Handles claims from submission to reconciling reimbursement
- Develop, revise, improve, implement, manage and keep current policies, processes and programs relating to claims processing
- Assumes responsibility for records management and ensures compliance at all levels and areas
- Conduct and/or actively participate in various forms of communication with team members, clients and partners
- Maintains and cultivates relationships with MCOs, billing partners, and accounting team members
- Represents the organization at various meetings, functions, and events
- At all times, conduct interactions with clients, team members and partners in a manner that advances Gateway Service’s culture and reputation
- Familiar with Virginia DBHS regulations and local, state, and federal laws
- Identify, recommend, and implement new processes, technologies, and systems to improve and streamline organizational processes and use of resources and materials
- Implements policies, practices, standards, and security measures to ensure high quality client care and team member development
- Maintains knowledge of emerging technologies and trends
- Knowledge of the principles, procedures, and best practices in Community Mental Health along with an intimate knowledge of Virginia DBHDS regulations and HIPPA requirements
KNOWLEDGE, SKILLS, AND ABILITIES
- Excellent verbal and written communication skills.
- Knowledge of the principles, procedures, and best practices in Community Mental Health along with an intimate knowledge of Virginia DBHDS regulations and HIPPA requirements.
- Excellent organizational skills and attention to detail.
- Strong analytical and problem-solving skills.
- Proficient with Microsoft Office Suite, Google Suite, and other related software.
- Current CPR Certification and First Aid Certification
- Must be able to apply principles of critical thinking to a variety of practical and emergency situations and accurately follow standardized procedures that may call for deviations
- Must be able to apply sound judgment beyond a specific set of instructions and apply knowledge to different factual situations
- Must be alert at all times; pay very close attention to details
- Must be able to work under stress on a regular or continuous basis
MINIMUM QUALIFICATIONS
- CPR and First Aid certified
- Must submit to and receive satisfactory results from a criminal background investigation and a registry check by the Department of Social Services
- A valid driver’s license and current copy of DMV driving record
- A copy of the declaration page of automobile insurance is required
- Must be able to apply principles of critical thinking to a variety of practical and emergent situations and accurately follow standardized procedures that may call for deviations
- Familiarity with Electronic Health Record Software is preferred.
EDUCATION AND EXPERIENCE
- High School Diploma or its equivalent.
- Associates degree or vocational school training preferred.
PHYSICAL REQUIREMENTS
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift 15 pounds at times.
A job offer may be initiated but will be contingent upon receiving satisfactory results of the criminal background and registry check. Employment will not begin until all required documentation for background and registry checks has been received and submitted.