COOK INLET TRIBAL COUNCIL, INC.
Billing Specialist - Valley
This position is responsible for timely and accurate billing activities including interactions with third party payers and participants and maintaining accurate records. This position requires a strong focus on Medicaid billing and an understanding of tribal health systems such as the Indian Health Service (IHS).
Duties and Responsibilities:
Ensure that all Recovery Services (RS) participants are screened and enrolled in any form of reimbursement for services including, but not limited to: Indian Health Services (IHS), private insurance, Medicaid, and self-pay.
Effectively communicate with participants as to specific information needed, reasons for requesting such information, and ascertain the accuracy of the information received.
Obtain necessary participant document such as proof of IHS eligibility, income verification for sliding scale fee and other eligibility documentation as required.
Assist participants with application for Medicaid, Food Stamps, Permanent Fund, and any other applicable payment sources.
Obtain all appropriate consents and releases of information required to release client information for billing purposes.
Provide information to participants regarding the cost of treatment.
Assess the financial situation of each potential client to establish a payment plan.
Assist new clients to prepare paperwork to establish responsibility for payment.
Work with staff and clients to ensure financial cost agreements are completed.
Submit invoices to participants for self-pay, unpaid co-pay and insurance deductible amounts.
Verify and maintain current coverage status information with third party payers on an ongoing basis for existing participants.
Maintain current files and billing records, and make changes as needed so that participant information on file is accurate and complete.
Work with other RS staff members to ensure that there is a shared understanding of billable services and that the staff knows and understands their responsibility with regards to entering billing information.
Review clinical billable notes for accuracy before submission to 3rd party payers as participants.
Prepare and submit invoices and claims for payment for reimbursement from third party payers.
Maintain accurate and updated accounts receivable and distribute a monthly Aging Report or as required.
Contact vendors to assist in collection for outstanding invoices.
Resubmit rejected claims.
Resolve insurance denials, Medicaid adjustments, prior authorization issues, clinical records request, and resubmission of claims.
Communicate with Data/Administrative Supervisor as needed with regard to discrepancies and complaints.
Provide reports on billing activities as requested by Data/Administrative Supervisor.
Act as liaison between the CITC Accounting Department, the Recovery Services staff and clients regarding all treatment billing.
Assist in sending past due accounts to collections.
Obtain and process all in-coming payments.
Resolve client/staff questions concerning billing statements or account information.
Provide support to data collection efforts when needed.
Attend State provided trainings regarding updates for Medicaid billing, regulations, HCPC and ICD-10 codes as needed.
Participate in scheduled internal/external meetings/trainings as requested.
Maintain confidentiality according to regulations, policies, and procedures.
Perform all other related duties as assigned.
Excellent organizational, attention to detail, and time management skills.
Demonstrated ability to communicate effectively with vendors, staff, and participants.
Demonstrated ability to work in a team environment.
Excellent verbal and written communication skills.
Strong problem solving skills.
Demonstrated ability to prioritize workload to meet deadlines and fulfill all responsibilities related to this position.
Strong knowledge of substance abuse treatment theory and programs.
Ability to work in a collaborative environment with joint responsibilities.
Strong computer literacy with experience in providing program support.
Excellent attention to accuracy, details, and fact reporting.
Demonstrated ability to work independently while maintaining efficiency and accuracy.
Demonstrated ability with the use and knowledge of mathematical skills including addition, subtraction, multiplication, division, fractions, decimals, percentages, and graphs.
Demonstrated ability to understand and carry out instructions furnished in written, oral, and/or diagram form.
High school diploma or GED.
One (1) year of experience doing clerical work in a medical office, clinical site, or related professional office.
One (1) year of experience with medical billing using a variety of clients such as Medicaid, IHS and private insurance agencies.
Experience with using billing software and heavy data entry.
Continued employment is contingent upon a satisfactory report from a state and federal background check.
Hiring preference shall be given to eligible and qualified Alaska Native/American Indian applicants pursuant to P.L. 93-638 Indian Self Determination Act.
The information provided in this description has been designed to indicate the general nature and level of work performed by incumbents within this job. It is not designed to be interpreted as a comprehensive inventory of all duties, responsibilities, qualifications and working conditions required of employees assigned to this job. Management has sole discretion to add or modify duties of the job and to designate other functions as essential at any time. This job description is not an employment agreement or contract.