Insurance Billing Specialist - Float

Position Summary:

The Insurance Billing Specialist float is responsible for performing a variety of billing, coding, cash posting, and insurance claim management tasks across multiple departments or locations. This role involves ensuring the timely reimbursement for services rendered, handling everything from claim submissions and follow-ups to posting patient payments. The specialist must also identify and resolve Coordination of Benefits (COB) issues or any other insurance-related discrepancies, ensuring accurate billing practices and compliance with regulations. The position requires adaptability, attention to detail, and strong communication skills to effectively manage the billing process and resolve any payment or insurance issues.

Responsibilities:

Key Responsibilities

• Review explanation of benefits from the insurance carriers to post appropriate payments and denial codes
• Insurance verification, claim submission and follow-up, billing and coding, cash posting, coordination of benefits (COB) and monitoring, insurance issues and billing resolution, compliance with HIPAA and relevant laws, regulations, and policies, accurate and up to date documentation, high standard of customer service
• Complete Applied Behavioral Health (ABA) billing including obtaining authorization for all payers that require prior authorization and authorization extensions
• Identify remittances with a secondary payer and take appropriate action to send to secondary carriers
• Analyze balance reports to ensure accurate postings
• Input zero payment vouchers and insurance denials from all payer sources in a timely manner
• Assist staff with payment and adjustment questions and research as needed
• Post manual payments not posted electronically; post allowances, adjustments, and write-offs/write-ups
• Process refunds and recoups within the EHR system

Maintain confidentiality of all business practices and adhere to all HIPAA guidelines/regulations

• Participate in Managed Care meetings for data updates as needed
• Respond to emails in a timely and professional manner
• Maintain current knowledge of CPT codes and descriptions
• Stay informed with current insurance billing requirements and changes
• Assist with special projects, and other duties as assigned

Perform other duties as assigned

Job Requirements:

The following requirements are those that are normally required for performance of this position. Any disabled applicant or incumbent who does not meet one or more of the requirements, but who can perform the essential function of the job (with or without reasonable accommodations) shall be deemed to meet these requirements.

Physical Requirements:

This position normally requires the physical demands of standing, walking, bending, lifting or performing other work requiring low physical exertion, talking and hearing and adequate vision on a regular basis to perform job requirements. These physical demands are required up to 90% of the time.

Non-Physical Requirements:

Education

• High School Diploma, Required
• College Degree or Certificate of Completion (Computer Science, Behavioral Analytics, Medical Billing Certificate, preferred

Experience

• 2 years' experience with proficiency in billing software, electronic health record (EHR) systems, and cash posting platforms.
• Knowledge of WA State data requirements related to community mental health
• 3 years billing experience required (physician billing preferred)

Special Skills

• Good Customer Service
• Knowledge of medical terminology, coding (CPT, ICD-10), insurance policies, COB guidelines, and cash posting procedures
• Able to work independently or as part of a team
• Ability to multi-task and strong attention to detail to ensure the accuracy of billing tasks
• Computer word processing using Microsoft Office and Google Docs, including excel and 10 key by touch

Employment is conditional upon:

• Being cleared by criminal background check and fingerprinting when required