Billing Specialist

Job Type Full-time Description

The Billing Specialist for NIA Services plays a crucial role in the organization's financial operations by managing and executing all tasks related to billing services provided to individuals receiving DDA support in Tennessee. 

This role involves ensuring the accurate and timely submission of claims to payers such as Managed Care Organizations (MCOs) and the Tennessee Department of Disability and Aging (DDA), processing payments, maintaining detailed financial records, and resolving any billing discrepancies or denials.

Requirements

[PLEASE PAY ATTENTION TO THE REQUIRED QUALIFICATIONS WITH * BY IT]

Billing and Data Entry

• Accurately enter MCO and DDA billing data from calendars or attendance records into appropriate billing systems (e.g., clearinghouse, Therap/PCP website).
• Submit claims for services rendered, including 1915c waiver and Katie Beckett Part B claims using platforms like Therap.
• Generate and send accurate invoices to clients reflecting the services provided.
• Process medical bills by sending them to patients and insurance providers.

Tracking and Follow-Up

• Track entries through the approval process and maintain logs documenting their status.
• Research claim denials and resubmit claims as required.
• Follow up on delinquent payments and resubmit billing as necessary.

Records Maintenance

• Maintain accurate records of billing and payment transactions.
• Update accounting records with issued invoices, processed payments, balances, and customer information.
• Construct billing folders and save copies of sweep transaction.

Customer Interaction

• Respond to customer inquiries and resolve billing-related issues.
• Handle complaints regarding bills from customers.

Collaboration

• Collaborate with other departments to streamline billing and collection processes.

Compliance

• Comply with company policies, procedures, and applicable regulations.
• Stay updated on changes in billing regulations and industry’s best practices.

ADDITIONAL DUTIES

• Upload agency cost plan listings into billing systems and update service details based on Individual Support Plans (ISPs) or service authorizations.
• Maintain spreadsheets tracking pending billing corrections and notify relevant managers upon completion.
• Review service notes to ensure alignment with billable services, addressing any needed corrections with management.
• Assist with the preparation of financial reports and analyses related to billing activities.

QUALIFICATIONS 

• High school diploma or GED required*, Associate's degree in a related field preferred.
• Relevant experience in Medicaid billing, particularly in healthcare or human services.*
• Knowledge of third-party payer requirements, including Medicare/Medicaid regulations.*
• Proficiency with billing software (e.g., Therap/PCP, TIMAS) and Microsoft Office Suite.
• Familiarity with coding systems like CPT and ICD-10 is beneficial.
• Strong attention to detail, excellent organizational skills, and effective communication abilities.
• Ability to work independently as well as part of a team.

Desired Skills

• Strong analytical abilities
• Effective customer service skills
• Ability to handle multiple tasks efficiently in a fast-paced environment

Salary Description $24-$26 per hour