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Variety Care · 4 weeks ago

Program Billing Specialist (67595)

Oklahoma City, OK

Full-time

Onsite

Entry Level

1+ years exp

Variety Care is a healthcare organization that works with clinical staff to ensure timely and effective billing processes. The Program Billing Specialist is responsible for entering billing data, verifying clinical documentation, and collaborating with management to maximize reimbursement.

Health CareMedicalNon Profit

Responsibilities

Enters billing data from clinical documentation to generate accurate billing charges in accordance with funding source requirements

Reviews and verifies incoming clinical documentation for completeness, accuracy, and compliance with timeliness and payer-specific standards

Collaborates with manager/supervisor to ensure electronic billing charges and corrections are completed timely to support maximum reimbursement

Researches insurance claim denials, determines claim validity, and adjusts and resubmits claims through appropriate submission methods when warranted

Inputs and maintains billing-related data in billing systems in accordance with established procedures and controls

Maintains required performance data and billing and collections metrics

Ensures eligibility and billing exceptions identified in the 271 eligibility file and 837 billing file are corrected and updated in the billing system in a timely manner; follows up with clinical staff to resolve data issues prior to the next billing cycle

Proactively identifies, prevents, and assists in correcting CDC errors in PICIS, and supports staff in determining CDC status and appropriate corrective actions

Proactively ensures all required eligibility information is obtained and updated timely to support accurate billing and maximum reimbursement; communicates barriers to timely and accurate billing to appropriate management

Responsible for staying knowledgeable about and adhering to HIPAA regulations as well as other state, federal and agency regulations related to confidentiality of consumer health information

Performs other duties as required and/or assigned by supervisor and/or executive staff

Responsible for notifying supervisors of any training deficiencies that impair the PBS's ability to perform their duties

Qualification

Medicare/Medicaid billingMicrosoft Office proficiencyGeneral computer skillsInterpersonal skillsVerbal communicationWritten communicationOrganizational skills