We are a private mental health group with offices in McLean, Reston, Manassas, Arlington, and Alexandria and offer a collaborative, rapidly growing practice of compassionate clinicians who work together to support our clients.
The Medical Billing Specialist role is a contract position. This person is goal oriented, knowledgeable of credentialing, contract management, CPT coding, batching, collections and accounts receivable. This position is responsible for leading and planning the billing operations. Primary duties include, but are not limited to: credentialing, coding, pre-billing, billing, claims processing cycle until adjudication, posting receipts, follow up on unpaid claims through weekly and monthly aging reporting of receivables and collections. The Medical Billing Specialist will work to obtain maximum reimbursements.
- Manage the credentialing process to ensure that clinical providers are linked to the appropriate payers per their specifications.
- Keeps contacts with insurance companies active and re-negotiates yearly to ensure highest reimbursement rates possible for services.
- Pre-auditing of billing with verification of completeness and accuracy of claims prior to billing
- Ensuring all claims are submitted with a goal of zero errors
- Accurately post all insurance claims
- Timely follow up on claims denials, exceptions, or exclusions
- Managing explanation of benefits (EOB) and alerting supervisor of unusual trends
- Utilizing monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days
- Assist with software configuration around billing coding, and billing matrices
- Oversee and streamline billing and collections processes and provide necessary development of workflows, procedures, and training needs relative to billing.
- Achievement of Key Performance Indicators (KPI’s) established in coordination with COO
- Perform additional duties as requested around accounts receivable and account management as defined by the Chief Operating Officer.
- Maintains current with regulations and governing bodies for insurance contracts to provide mental health services.
- Plan and implement quality assurance for all processes
- Special program/billing planning and implementation
- Regularly meet with COO and CEO to discuss and resolve reimbursement issues or billing obstacles
- Attend mandatory quarterly staff meetings
The individual is responsible for designing, implementing and enforcing policies and procedures, as well as streamlining effective billing processes.
- Month-end closing of the billing group information
- Proven ability to perform strategic planning and priority setting for a billing department
- Proven track record for improving process efficiencies and solving problems
- Strong leadership skills with an ability to train others
- Detail oriented
- Excellent communication skills both written and verbal, and internal personal skills
- Excellent analytical and problem solving skills
- Medical Coding Certification is mandatory
- Experience with Office Ally practice mate and EHR a plus.
We take great pride in our holistic approach to healing that addresses physical, emotional, relational, and environmental factors of an individual. The position is located in the firm’s McLean VA headquarters and will serve as the focal point for all patients seen from our current Northern Virginia offices. This is an expanding role with room for personal and professional growth.
If you are interested in becoming a highly valued member of our dynamic team, please submit your resume and cover letter to email@example.com.
All your information will be kept confidential according to EEO guidelines.