Inpatient Billing Specialist
Medical Billing & Coding
Apalachee Center, Inc. is best known for helping individuals and families of North Florida succeed in recovering from emotional, psychiatric, and substance abuse crises. Apalachee Center, Inc. provides comprehensive behavioral health services across 8 counties (Franklin, Gadsden, Jefferson, Leon, Liberty, Madison, Taylor, and Wakulla Counties).
Apalachee Center, Inc. offers competitive benefits for our full-time positions to include health, dental, vision, basic life insurance, long term disability, paid time off, and more.
Overview:
Billing and collection of psychiatric inpatient days and charges via complex, service-specific accounting/insurance system.
ESSENTIAL/CORE JOB-SPECIFIC DUTIES AND RESPONSIBILITIES
1. Communicate to Inpatient Billings Supervisor patient information including, but not limited to, diagnostic coding, policy-holder information, unit transfers, patient benefits.
2. Review all inpatient admissions for appropriate documentation of insurance information and potential for third party reimbursement sources. Coordinate follow-up on additional information required with Inpatient Billings Supervisor.
3. Complete all pre-billing processes and edits including but not limited to reviewing and posting day tickets events, pharmacy charges, and discharge information.
4. Process inpatient billing to assigned payer sources, i.e, insurance, guardian, or self-pay.
5. Process explanation of benefits (EOBs) from assigned payer sources, including posting payments, rebilling co-pays and/or deductibles, and adjusting receivables accordingly.
6. Process denials by coordinating with Utilization Review Coordinator where necessary, communicating with insurer, providing additional documentation, submitting corrected billings, or any other step required based upon denial code.
7. Maintain written record in patient financial records of all steps taken to reverse denials.
8. Generate aged receivables report on a monthly basis (or more often as needed) for review and follow-up of outstanding balances. Submit monthly report to Inpatient Billings Supervisor.
9. Review accounts receivable greater than ninety days with Inpatient Billings Supervisor.
10. Present potential write-offs for approval to Inpatient Billings Supervisor.
Education/Experience:
Apalachee Center, Inc. offers competitive benefits for our full-time positions to include health, dental, vision, basic life insurance, long term disability, paid time off, and more.
Overview:
Billing and collection of psychiatric inpatient days and charges via complex, service-specific accounting/insurance system.
ESSENTIAL/CORE JOB-SPECIFIC DUTIES AND RESPONSIBILITIES
1. Communicate to Inpatient Billings Supervisor patient information including, but not limited to, diagnostic coding, policy-holder information, unit transfers, patient benefits.
2. Review all inpatient admissions for appropriate documentation of insurance information and potential for third party reimbursement sources. Coordinate follow-up on additional information required with Inpatient Billings Supervisor.
3. Complete all pre-billing processes and edits including but not limited to reviewing and posting day tickets events, pharmacy charges, and discharge information.
4. Process inpatient billing to assigned payer sources, i.e, insurance, guardian, or self-pay.
5. Process explanation of benefits (EOBs) from assigned payer sources, including posting payments, rebilling co-pays and/or deductibles, and adjusting receivables accordingly.
6. Process denials by coordinating with Utilization Review Coordinator where necessary, communicating with insurer, providing additional documentation, submitting corrected billings, or any other step required based upon denial code.
7. Maintain written record in patient financial records of all steps taken to reverse denials.
8. Generate aged receivables report on a monthly basis (or more often as needed) for review and follow-up of outstanding balances. Submit monthly report to Inpatient Billings Supervisor.
9. Review accounts receivable greater than ninety days with Inpatient Billings Supervisor.
10. Present potential write-offs for approval to Inpatient Billings Supervisor.
Education/Experience:
- A high school diploma or its equivalent.
- Two years of medical clerical/insurance experience.
- Must have excellent telephone/customer relations skills and experience on 10 key calculator.