SPECIALIZED DUTIES FOR BILLING: • Verifies insurance & enters eligibility and financial information in computer system. • Determine client’s maximum monthly liability and monthly payment. • Verifies insurance coverage from insurance companies for outpatient and inpatient clients. • Obtains necessary releases, prior authorizations and insurance information for billing purposes for inpatient admissions. • Handles billing, collections, reimbursements for Children’s Long Term Support services, Birth-3 services, outpatient and inpatient charges on a computerized system. Runs edit reports and verifies billing reports for accuracy. Processes submits and resubmits all bills to primary insurance and re-bills to all second and third insurances by both paper and electronic formats are required for various department programs. Process and bills all inpatient and outpatient private pay bills. • Complies and posts daily inpatient census to create charges. • Maintains direct contact with clients, insurance companies and other third-party payers, which includes clarification of coverage for services and explanation of client liability and eligibility. • Responsible for up-to-date knowledge of Medicaid, Medicare, HMO policies, procedures and regulations and maintaining agency compliance. • Receives payments for clients for services rendered, records amounts received for client services, and notifies clients or responsibility party of delinquent accounts. • Assist with set up of programs and services for accurate billing in EHR system. REQUIRED EDUCATION, EXPERIENCE, TRAINING, AND CERTIFICATION: • Graduation from an approved two (2) year program in Accounting or equivalent experience is preferred. • Medical billing experience is preferred. Knowledge of CPT codes, medical billing codes, and insurance billing processes. • A minimum of two (2) years of work experience including accounting, bookkeeping or billing. • Prior to hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the position.