The Billing Specialist will be responsible to gather and collect the necessary data, calculate charges and fees, and create invoices to collect payments for services provided by the agency. This role provides critical support for the Finance operations at the Agency to ensure quick and accurate billing for services provided by the agency.
Responsible for completing all aspects of the revenue cycle, including, but not limited to;
Submits billing for processing in a timely manner as dictated by supervisor or per each contract or grant, and provides reports to management.
Conducts appropriate claims tracking and resolution.
Monitors reimbursement to ensure accurate claims payment, conducts analysis and research to appropriately appeal denied claims, ensures appeals are filled timely, and assumes responsibility for conducting the appeals process when required.
Maintains payer communications files, responds to inquiries from payers and patients regarding insurance claims status, and submits appropriate rebilling.
Maintains cash sheets in date order and ensures that each are accounted for every month.
Assists in maintaining compliance with current governmental and payer regulations.
Verifies benefits with Medicaid, commercial insurance companies, the Mental Health Boards and other payers or funding sources to obtain client benefits and funding information and communicates information obtained to clients and/or staff.
Maintains client financial and communication records and ensures that all necessary paperwork is accounted for.
Determines ability to pay and facilitates collection of co-pays, deductibles, and private pay balances.
Coordinates with Fintake staff during routing of agency referrals to ensure efficiency and accuracy of information.
Obtains enrollments with the local board for reimbursement and follows up on outstanding requests.
Collaborates with clinical staff to obtain and maintain authorizations for services.
Runs receivables report monthly and performs follow-up to ensure payment is received and A/R is maintained within established guidelines.
Runs Billing and A/R reports for validation and audit purposes.
Submits electronic claims daily and prepares and submits paper claims as needed.
Posts payments to client accounts and performs collections activities on past due accounts.
Reconciles client accounts and recommend adjustments as appropriate.
Performs audit of claims in accordance with policy/procedure.
Prepares monthly invoices in accordance with grant and funding requirements.
Monitors contract utilization for compliance with agreements.
Coordinates with program staff to ensure that funding requirements are met.
Creates and processes electronic invoices from billing software.
Maintains a file for each contract with billing documentation and contract information.
Escalates Billing/Accounts Receivable questions or concerns to the Team Lead.
Must have analytical ability to be self-sufficient in performing essential functions.
Must be able to remain in a stationary position 75%-100% of the time.
Must be able to visually read written and digital information.
Must be able to visually determine the accuracy, neatness, and thoroughness of work assigned and/or to make general observations of facilities or structures.
Must be able to receive detailed information through oral communication.
Must be able to clearly and confidentially communicate with OhioGuidestone employees, clients, students, participants, and other stakeholders.
Must adhere to all Our Promise Values and Guiding Principles.
