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CCS Billing Specialist in San Antonio, TX at Jordan

Date Posted: 1/26/2018

Job Snapshot

Job Description

Summaryof Job Title: The Billing Specialist is directly responsible for collectingagency revenue for the programs he/she is assigned.  To perform the collection of agency revenue,the Billing Specialist performs or coordinates all operations necessary to billpayors for claims and then ensure that all payments are received and accountedfor correctly.  When payments are notreceived or are not received correctly, the Billing Specialist is thenresponsible for all collection efforts, including making necessary correctionsand resubmitting the itemized billing claim. The Billing Specialist is also responsible for tracking trends in thebilling process and notifying the Director of Reimbursement and Manager of any significant trends.  TheBilling Specialist assists in the training of all personnel who are involved inthe billing process to ensure accurate, quick and correct billing inputprocedures.  The Billing Specialistprepares monthly reports aging reports to track account receivable and rejections.




BillingOperations:  ComponentProportion 70%


  • Prepares and sends/transmits billing to TMHP or private payors for the programs he/she is assigned.
  • Ensures that all billing is sent/transmitted and that payments or reimbursements are received in a timely manner.
  • Balances all individual billing according to the client’s care plan.                                                                                                                                              
  • Reviews billing forms for accuracy and completeness before sending to payors.
  • Maintains an itemized billing record each month for each client that indicates the services provided.
  • Receives payments/reimbursements and posts them to the accounts receivable ledger.
  • Reviews all payments/reimbursement reports for accuracy; identifies errors and corrects errors prior to re-submitting to the payor.
  • Corrects all returned or denied billings prior to re-submitting to payor.
  • Communicates with payors when necessary to facilitate reimbursement.


AdministrativeSupport Operations:  ComponentProportion 30%


  • Maintains a current accounts receivable aging report for each program.
  • Tracks and monitors the monthly rejection report.
  • Maintains current knowledge of each payor’s billing/reimbursement guidelines.
  • Facilitates professionalism with payor entities.
  • Assist in the training of all personnel involved in the billing process.
  • Understands, adheres to, and performs all duties in accordance with established agency policy and procedures.
  • Attends training seminars, workshops and other educational activities in an effort to keep abreast of new developments and changes related to the billing/reimbursement process.
  • Provides Director of Reimbursement with recurring status reports (Rejection Report and A/R Report.)
  •  Provides Director of Reimbursement with continual information regarding billing trends.

Job Requirements

Education,Previous Work Experience, Skills/Abilities and General Requirements forposition

Education/Experience

  1. Must have graduated from high school or received a Graduation Equivalent Degree (G.E.D.).
  2. Completion of at least two (2) years college-level education in a business or healthcare field preferred.
  3. Minimum of one (1) year’s experience in Medicaid billing operations preferred.
  4. Working knowledge Medicaid electronic billing preferred.

Skills/Abilities

  1. Able to operate an 10-key adding machine accurately, preferably by touch.
  2. Have the ability to think analytically.
  3. Have the willingness and ability to operate in a high stress environment and to aggressively seek payment from payors when necessary.
  4. Possess well developed interpersonal skills.
  5. Have the ability to organize work and schedule effectively.
  6. Be willing and able to foster the TEAM philosophy and continuous quality improvement applications.
  7. Have the ability to operate office equipment such as computers, copiers, phone systems, adding machines and fax machines
  8. Have the ability to motivate others in a positive manner.
  9. Have good verbal and written communication skills.

Other

  1. Must have satisfactory references from previous employers.

  2. Must be able to pass a criminal history and Office of Inspector General background check.

  3. Must be able to pass a random drug test.

  4. Must have a dependable vehicle and a valid driver’s license.

    Risk Exposure (bloodborne pathogens, etc.) Low Risk