Outpatient Billing Specialist

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 behavioral health outpatient services via complex, service-specific accounting/insurance system.

ESSENTIAL/CORE JOB-SPECIFIC DUTIES AND RESPONSIBILITIES 

1.         Coordination and communication with various outpatient staff regarding patient information including, but not limited to, diagnostic coding, policy-holder information, and patient benefits.

2.         Complete all pre-billing processes and edits for assigned payer sources.

3.         Process outpatient billings to assigned payer sources.

4.         Process explanation of benefits (EOB’s) from assigned payer sources, including posting of payments, rebilling co-pays and/or deductibles, and adjusting receivables accordingly.

5.         Process denials by coordinating with Utilization Review department where necessary, communicating with insurer, providing additional documentation, submitting corrected billings, or any other step required based upon denial code.

6.         Review aged receivables report for assigned payer sources on a monthly basis for outstanding balances. Perform necessary follow-up.

7.         Review accounts receivable greater than ninety days with DP/Billings Supervisor.

Qualifications

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.