SUNRISE SERVICES INC

  • Everett, WA


  • Permanent

  • Full-time

Come work for a well established company with a lot of heart!

General Responsibilities: Under general supervision of supervisor, the Medical Billing Specialist is responsible for timely submission of claims to insurance companies from a wide variety of medical providers, as well as monitoring and ensuring payment for medical services are received in a timely manner. Provide customer service; perform precise calculations; enter data; submit medical billing documents; review and reconcile work; and maintain document files.

Essential Functions: (Tasks, Responsibilities, and Competencies. May not include all duties of this job)

Review patient’s bills for accuracy and completeness; obtain missing information.

Review and understand all billing contracts and implement proper billing and collection processes.

Maintain up to date knowledge of insurance, especially Medicare and Medicaid, rules and guidelines.

Identify insurance company or proper party to be billed; identify and bill secondary or tertiary insurances.

Perform coding and billing tasks on a computerized health information technology system.

Utilize a combination of electronic health records to perform billing duties; maintain an accurate, legally compliant medical record.

Process claims as they are paid and credit accounts accordingly.

Review insurance payments for accuracy and compliance with contract.

Review denials or partially paid claims and work with the involved parties to resolve the discrepancy.

Manage assigned accounts ensuring outstanding/pending claims are paid in a timely manner and contact appropriate parties to collect payment.

Communicate with health care providers, patients, insurance claim representative and other parties to clarify billing issues and facilitate timely payment.

Consult supervisor, team members and appropriate resources to solve billing and collection questions and issues.

Maintain work operations and quality by following standards, policies and procedures; escalate compliance issues to supervisor.

Prepare reports and forms as directed by supervisor.

Perform a variety of administrative duties including but not limited to: answering phones, faxing and scanning of documentation.

Provide excellent and professional customer service.

Provide training and cross-training to other Accounting employees as assigned.

Assist Accounts Payable in the proper recording of flex funds and verification of interpreter and consultant services.

Perform other duties as assigned.

Essential Requirements: (Any Equivalent Combination of Knowledge, Skills, Abilities, Education, and Experience)

Education: High school diploma or equivalent required.

Experience: Two years of current experience in behavioral health billing and claims processing.

Other Considerations:

Knowledge of behavioral health system, including Tricare, Medicaid, Medicare and private insurances.

Knowledge of and compliance with HIPAA regulations

Knowledge of and ability to utilize Sage and Credible software preferred.

Knowledge of and ability to utilize Microsoft software products (Word, Excel, and Outlook) required. Ability to learn other software as needed.

Data entry skills and accuracy.

Maintain strict confidentiality.

Very strong attention to detail.

Excellent verbal and written communication skills.

Organization, time-management, prioritization, documentation, and problem-solving skills.

Monster

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