Job Description

Job Description

Job Description

Description:

FULL-TIME

Location: Akron, OH - In-Person

Applicants must be located in Northeast OH.

Job Summary

The Billing Specialist is responsible for ensuring that all providers are enrolled and active w/multiple payers to ensure timely billing of services. The role is responsible for processing, verification, and preparation of all commercial claims for insurance clients. The position maintains records of payments and handles administrative detail and follow-up.

Essential Functions and Duties:

• Support the creation and implementation of a streamlined provider credentialing process to ensure appropriate enrollment of clinical staff, ensuring service delivery coincides with efficient and timely billing.
• Manage and update provider credentialing tools and processes to ensure there are no lapses in service delivery due to the inability to bill for services.
• Daily posting of Insurance payments and electronic remittance adviser (ERA) files (a.k.a. 835 transactions).
• Provide insurance verification and prior authorization for clients.
• Daily posting of Explanation of Benefits (EOB) and Explanation of Payments (EOP) for non-payments; management of denials and rebill/ Coordination of Benefits (COB) issues.
• Weekly compile and transmit claims
• Upload EOB into scanning solution (eBridge).
• Assists with prior authorization/benefit coordination and rebill claims, as needed.
• Assists with weekly submission of Centers for Medicare & Medicaid Services (CMS) claims
• Identify and assists in resolution of errors for all Insurance claims
• Performs regular review and investigates unpaid claims and other accounts receivable management projects.
• Assist clients in accessing and trouble shooting our Payment Hub, an online payment system.
• Fixes and Reversal of Payment issues on the Ohio MITS portal
• Maintain orderly, current, and up-to-date records of client insurance coverage to ensure accurate client files
• Assist other staff with general inquires and requests, as needed
• Unique responsibilities as assigned by supervisor or Management

Qualifications:

Associate degree or equivalent education from a two-year college or technical school with major in Medical Billing/Coding and/or Accounts/Receivable, plus 3-5 yrs. billing experience.

Knowledge, Skills and Abilities:

• Excellent and proven attention to detail
• Strong computer/software management skills
• Excellent math skills.
• Ability to work well within a team environment
• Ability to work with a diverse group of people

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act (ADA) of 1990 and the Americans with Disabilities Amendments Act (ADAA) of 2008.

While performing this job, the employee is regularly required to sit, talk, and hear. This job requires filing, opening, and closing of file cabinets, and the ability to bend and/or stand as necessary. This job is frequently required to use hands; handle, feel and reach with hands and arms; and may occasionally lift and/or move files and other related materials up to 20 pounds.

The position requires regular use of a computer, calculator, and telephone.

Work Environment:

This job operates in a professional office environment and in the community. While performing the duties of this position in the office this role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets. The employee will occasionally travel by automobile and is exposed to changing weather conditions.

The employee may be required to drive daily to nearby locations for meetings or visits to assigned work sites.

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

EEO Statement

Red Oak is proud to be an equal opportunity workplace. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

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