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AI Summary

The Medical Billing Specialist acts as a bridge between practitioners and insurance companies to manage revenue performance and billing support. They are responsible for verifying insurance benefits, processing payments, and maintaining accurate patient and financial records.

The award-winning team at Executive Mental Health (EMH), is a leading behavioral healthcare group in the State of California, who is seeking a Medical Billing Specialist with 3-5 years of experience for a full-time position with the company to support the growth of EMH as a trusted provider of integrated mental healthcare and play a critical role in healthcare. The position offers competitive pay and benefits such as fully covered healthcare, 401K retirement plan, paid parental leave, and more.

 

Job description:

 

As a valued employee of Executive Mental Health, you’ll be part of a team dedicated to delivering high-quality billing support to our clinicians offering patient care across California. Our medical billing experts benefit from the stability of an administrative position in a fast-growing industry, enjoy the support of and camaraderie among their peers, and opportunities for professional growth as an essential part of the company’s functioning.

 

Reporting directly to the Head of Billing, the Medical Billing Specialist acts as the bridge between the team of practitioners and insurance companies and contributes to the practice's overall revenue performance. As an advocate for our patients, you’ll be working with a team making a positive difference in the lives of the people of our community.

 

The ideal candidate will offer from 3 to 5 years of experience handling accounts receivable, including collections, private billing, census reporting, Medicare, Medicaid, and Private insurance management (HMO); and maintaining accurate accounting records.

 

This position is remote with a PST preferred time zone. A stable internet connection is required and virtual communication via Microsoft Teams is required.

 

Responsibilities:

Act as a valued member of the EMH team
  • Demonstrate respect and compassion in every interaction.
  • Conduct oneself with the highest degree of honesty and integrity in every interaction.
  • Demonstrate a passion for caring as evidenced by interaction with co- workers, residents, families, and visitors.
  • Routinely attend department meetings and on-going in-service and training programs, to present and exchange pertinent information.
  • Relay information between licensed staff and other staff members, and provide them with updates as needed.

 

Support EMH’s strategic planning and optimal financial reporting
  • Contribute billing information needed for strategic plans and reviews.
  • Implement production, productivity, quality, and customer-service standards.
  • Resolve problems and identify billing system improvements.

Ensure timely verifications & referrals

  • Confirm/Verify insurance benefits and financial data with the appropriate carrier via on-line verification systems or telephone inquires.
  • Obtain and update demographic, next-of-kin, and insurance information, including referrals, authorizations and signatures on patients following the Health Insurance Portability and Accountability Act (HIPAA) rules and regulations.
  • Respect patient confidentiality and withholds restrictive information according to HIPAA guidelines.
  • Collect appropriate documentation for managed care programs regarding referrals and authorizations.

 

Facilitate payment processing, reconciliation, and reporting

  • Adhere to established reporting procedures to ensure that the numbers balance.
  • Maintain working knowledge of all required computer systems.
  • Maintain current and accurate computer data.


Offer administration team support

  • Welcomes visitors by greeting them, in person or on the telephone; answering or referring inquires. Answering, forwarding, screening phones calls and routing calls as necessary.
  • Assist with administrative tasks including copying, faxing, taking notes, making travel plans but not limited to scanning of medical records
  • Schedule appointments according to the templates/departmental scripts while meeting business unit scheduling accuracy requirements.
  • Schedule appointments according to the physician templates for similar types of physicians, generally at one office or multiple session timeshares (single specialty phone room or front desk environment).

The job description above includes duties that are essential functions, or fundamental duties. The essential functions of the Medical Billing Specialist may differ based on job performance, staffing needs and demand.

 

Desired skills and aptitudes
  • Professional integrity: Consistency, compassion, cultural competence, and sensitivity.
  • Critical thinking: Excellent judgment and creative problem-solving skills, including negotiation and conflict resolution.
  • Communication: Strong written and oral communication skills; excellent interpersonal skills.

 



Requirements

Qualifications (required)

  • Minimum of 3 years of experience working as a Billing Specialist (required)
  • University Degree (desired)
  • High School Degree or equivalent (required)





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