General Summary

The BY YOUR SIDE Billing Specialist’s primary focus is to support and provide assistance in medical billing and charge entry of insurance payments for all BY YOUR SIDE clients. Billing Specialist will ensure our clients’ accounts are updated and displayed accurately in a timely manner. The Billing Specialist will also work closely and provide assistance to clinical teams as needed to resolve any outstanding billing and/or insurance issues.

The Billing Specialist operates in a professional and clinical environment. The employee may regularly lift and /or move up to 10 pounds, frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Functions, Duties & Responsibilities

Core duties and responsibilities include the following:

• Heavy A/R reconciliation activities including; evaluating EOBs, calling insurance companies on denials, sending corrected claims, submitting medical necessity reports and compiling appeals
• Work closely with behavioral health professionals and administrative staff to organize and submit therapy authorizations according to insurance company specifications
• High volume communication via phone and email with insurance companies and clients
• Obtain detailed insurance verifications including precertification of services for potential clients
• Some payment posting

Skills Required

Include demonstrated competencies and physical, mental, & interpersonal skills.

• High School Diploma or GED Equivalent.
• Minimum of (2) years of medical A/R experience including EOB evaluation and communicating with commercial insurance companies via phone, email, and websites
• Must have experience identifying A/R payment issues and resolution
• Attention to detail and ability to monitor own work for accuracy
• Must be able to communicate effectively and problem-solving skills
• Thrive in a fast-paced growing environment
• Behavioral Health billing experience a plus