Insurance Verification & Billing Specialist
Anchor Behavioral Solutions
59 Main Street, Ste 310, West Orange, NJ, 07052
Job Summary
Responsible for managing the entire billing processes including submitting claims and following up on unpaid accounts while specializing in the intricacies of Behavioral Health billing requirements. This role requires a solid understanding of billing concepts, processes and procedures; does other related duties.
This is an in-person position, reporting to our main headquarters in West Orange, NJ 07052.
Essential Duties and Responsibilities
Note: The responsibilities outlined for this position are provided as examples and are intended to illustrate the scope of the role. These examples are not exhaustive and may vary based on the specific requirements of the position. Additional duties aligned with the role’s objectives may also be assigned.
Prepare and submit accurate billing data and medical claims for behavioral health services to insurance companies and government payers.
Verify patient insurance coverage and eligibility, ensuring all required authorizations and documentation are in place.
Monitor accounts for delinquent claims and establish payment arrangements with patients as necessary.
Work claims and claim denials to ensure maximum reimbursement for services provided.
Handle rejected claims promptly, conducting thorough investigations to identify discrepancies and resubmitting claims as required.
Maintain a comprehensive understanding of billing regulations and compliance requirements specific to Applied Behavior Analysis (ABA) and Division of Developmental Disabilities (DDD), ensuring adherence to legal and insurance guidelines.
Collaborate closely with healthcare providers to ensure accurate documentation is present for each claim submitted.
Keep abreast of changes in billing codes, insurance policies, and compliance regulations so that all processes remain current and efficient.
Maintain the highest standards of patient confidentiality as per Health Insurance Portability and Accountability Act (HIPAA) regulations.
Requirements
High school diploma or GED required.
Bachelor's degree from a four-year college or equivalent preferred.
Minimum of 2 years’ experience in medical billing, behavioral health preferred.
Familiarity with state-specific billing requirements.
Licenses
Certification in medical billing and coding (AAPC, AHIMA) is preferred.
Knowledge and Abilities
Proven experience as a Medical Biller, preferably in behavioral health.
Ability to read, write, speak, understand, or communicate in English sufficiently to perform the duties of this position.
Proficiency in medical billing software and electronic medical records. Training and/or experience in Rethink, Tebra and Therap are highly desirable.
Excellent attention to detail and accuracy, with the ability to identify and resolve discrepancies effectively.
Familiarity with behavior health billing regulations and requirements, including documentation and submission procedures.
Proactive attitude towards staying updated on changes and updates in billing software.
Proficiency in Google Docs and other relevant software applications.
Strong analytical skills with the ability to interpret data and generate reports from billing systems.
Strong understanding of billing processes and procedures, including knowledge of insurance billing regulations.
Excellent analytical skills with a strong attention to detail to ensure accuracy in billing processes.
Ability to manage multiple priorities effectively and work independently to meet deadlines.
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