Advanced Billing Specialist 1057
Washington County Mental Health Services, Inc. | Barre, VT
SUMMARY OF POSITION: Responsible for billing and recording of payments in a timely and accurate manner. Billing and other duties will include some or all of the following: Entry of In-Takes, Maintain the electronic medical records demographic screens, Reimbursement Set-up (added Insurance), Title XIX Medicaid, Payment Reform Case Rate encounter claims and various funding specific billing.
General duties and responsibilities may include:
- Advanced knowledge of the functionality, processes and requirements of the billing system:
- Entering In-takes for new clients and updates on existing clients.
- Electronically or manually submitting billing for payment.
- Processing and reconciling Medicaid Remittance Advice files and/or other payments.
- Researching denied claims and either resubmitting or denying claims in the billing system.
- Verifying the accuracy of fee information contained on Client Intake form and information on client’s insurance coverage and sign form that are needed.
- Advanced electronic billing functions: services corrections resulting from internal monitoring procedures, paybacks and recoupments.
- Producing and distributing reports as needed.
- Maintaining a thorough knowledge of all coding requirements as they pertain to Billing and the electronic medical record System. This to include (but not limited to) 3rd Party coding, Title XIX Medicaid coding and all agency coding requirements.
- Problem solving regarding unbilled services, incorrect service / reimbursement combinations, incomplete client demographic, service records and client accounts, and resolution of non-compliance.
- Assisting clinical staff with coding or billing questions either by phone or by meeting with staff to explain and review program specific coding requirements.
- Assisting clients with questions/problems regarding to their type of insurance coverage.
- Assisting with the maintainance of all forms that pertain to the Billing Departments.
- Other duties as assigned by Billing Supervisor.
Education: Associates degree and /or 4-5 years’ experience in medical billing and coding.
Experience: Prior experience with computerized billing systems required. Knowledge of Vermont Title XIX Medicaid Regulations. Experience with Microsoft Excel, Word and Outlook. Knowledge of basic accounting and general ledger desirable.