Billing Specialist – Patient Accounts

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🕒 Maio 22

🌲 North Carolina – Remoto

🌲 North Carolina – Remote

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

📊 Especialista em Faturamento

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Carolina Center for ABA & Autism Treatment

SiteLinkedInTodas as Vagas

201 - 500 funcionários

Fundada em 2008

⚕️ Seguro de Saúde

📚 Educação

💰 Private Equity Round em 2012-12

Healthcare Insurance • Education

O Carolina Center for ABA & Autism Treatment é dedicado a melhorar a vida de crianças com autismo, suas famílias e suas comunidades. O centro oferece serviços especializados utilizando a Análise Comportamental Aplicada (ABA) para ensinar habilidades que impactam na qualidade de vida das pessoas, abrangendo áreas como comunicação, atividades diárias e autocuidado. Eles empregam Analistas Comportamentais Certificados e Técnicos de Comportamento Registrados para desenvolver programas de cuidados personalizados para os clientes. O centro oferece programas adaptados às necessidades únicas de cada cliente e suas famílias, enfatizando a intervenção precoce e o desenvolvimento de habilidades.

Descrição

• Manage patient responsibility accounts with kindness and professionalism • Develop and maintain flexible payment plans tailored to each family's unique financial circumstances, while ensuring ongoing adherence to agreed upon plans • Maintain detailed records of all collection activities, payment arrangements, and family communications • Monitor A/R aging reports to prioritize collection efforts • Process patient payments and apply them accurately to appropriate accounts and services • Research and identify financial assistance programs, grants, and community resources offering financial support for families receiving autism services • Proactively connect families with autism-specific funding organizations and state assistance programs, and nonprofit resources • Maintain a comprehensive database of local and national resources for easy family referrals • Create educational tools and step-by-step guides for families to independently and easily access available financial assistance programs • Advocate for families during financial hardship by exploring all available support options • Primary point of contact, managing relationship with third-party automated insurance verification partner • Manage our automated insurance verification process using our third-party benefits verification platform for all new intake clients and ongoing verification for existing clients • Review monthly eligibility checks to ensure continuous coverage and proactively identify policy changes • Determine and communicate to families applicable ABA coverage limits and exclusions, deductibles, copayments, and authorization requirements • Provide clear, understandable explanations to families about their insurance benefits, coverage details, and anticipated out-of-pocket costs based on verification results • Maintain accurate and up-to-date insurance information in patient records and promptly update any changes identified • When insurance changes occur, coordinate seamlessly across authorizations, scheduling, credentialing, and billing teams to ensure uninterrupted continuation of care • Identify potential coverage gaps through platform reporting and work with families to secure alternative funding sources before service interruption • Troubleshoot any platform issues and escalate complex verification cases to vendor support when needed • Reprocess insurance claims when patient financial obligations have been incorrectly calculated or applied by insurance carriers • Prepare and file formal appeals for incorrectly denied claims, including compilation and submission of supporting clinical documentation • Track appeal outcomes and follow up on pending decisions within established timeframes • Maintain detailed logs of all reprocessing activities and communicate outcomes to relevant stakeholders • Complete Electronic Funds Transfer (EFT) enrollment applications for new insurance payors • Set up Electronic Remittance Advice (ERA) enrollments to streamline payment processing and reconciliation • Maintain current enrollment status for all active insurance contracts and renew as needed • Proactively troubleshoot EFT and ERA processing issues and coordinate resolution with payor representatives • Update banking and contact information for electronic payment systems as organizational changes occur

🎯 Requisitos

• 1-3 years of experience in healthcare billing/collections, health insurance interactions, or patient financial services • Experience with insurance verification, claims processing, and accounts receivable • Knowledge of healthcare billing regulations and HIPAA compliance requirements • Strong customer service background with experience in sensitive financial conversations • Excellent communication skills, both written and verbal • Ability to resolve complex roadblocks independently and maintain diligent follow-up processes • Willingness to go above and beyond to connect families with resources and help them navigate payment for services • Familiarity with ABA Services preferred (CPT Codes 97151-97158) and Medicaid eligibility • Familiarity with EHR systems (CentralReach preferred), and Microsoft Office Suite (Excel, Word, Outlook) • Detail-oriented with strong organizational and time management skills • Ability to work independently and manage multiple priorities in a fast-paced environment • Familiarity working with both commercial insurance and government-funded (i.e., Medicaid and TRICARE) healthcare payors • Demonstrated experience driving payor accountability – comfortable pushing on payors and advocating for insurance coverage and timely claims payment on behalf of clients • Experience working with families or in pediatric, third-party reimbursed healthcare settings preferred

🏖️ Benefícios

• KBH is committed to creating a diverse environment • Equal opportunity employer • All qualified applicants will receive consideration • Supporting families throughout their ABA journey • Encouraging exceptional people to think big, have fun, and do good