Title: Medical Billing SpecialistFLSA Status: . 5 Part-time, NonexemptLocation: St. Paul, MN 55107Purpose: The Medical Billing Specialist is responsible for a variety of accounting functions for client billing, including verification of eligibility information, and resolution of a variety of problems. They follow up on submitted claims and patient billing, including resubmitting claims and resolving problems.Key Responsibilities: Duties and Responsibilities:Process third-party billings, record cash receipts, and follow-up on unpaid submitted claims. Ensure current insurance coverage or payment source is updated in the billing system. Processes electronic medical billing to third parties for reimbursement and enter cash receipts. Follows up on submitted claims; monitors unpaid claims, resubmits claims as necessary. Researches and responds by telephone and in writing to insurance coverage issues and billing issues. Processes client statements for private pay clients and verifies accuracy of input to reports generated. Create manual invoices, client statements and apply payments received. Manually enters patient and insurance payments into Credible depending on the program and its requirements. Automatically downloads ERAs into the Credible system, Manually processes invoices for specific Guild programs and verifies accuracy of the clients being billed on those invoices. Provides the completed invoices to the Billing Manager to authorize before mailing. Manually generate CAPP statements and provide them to the Program Director to review before mailing. Authorizations, insurance verification and backup and other duties as assigned, when needed. As a back-up, works with PAs to initiate authorizations for required programs and manage those authorizations. As a back-up, verify insurance coverage for all new and existing clients on a monthly basis and set up insurance on the client's account for accurate billing. Other duties as assigned. Required Skills/Abilities: Basic understanding of serious and persistent mental illness, including common diagnoses, and the challenges faced by those who experience symptoms. Understanding of mental health and medical terminology. Ability to understand the relationship and interconnectedness between program and accounting functions and ability to function as liaison to ensure accurate and efficient billing process. Knowledge of medical insurance claims, billing procedures, and documentation. Knowledge of revenue cycle management (RCM) along with accounts receivable and aging system and processes Intermediate problem-solving and analytical skills including the ability to research issues and gain additional information in order to resolve issues. Basic math, bookkeeping, and accounting skills. Knowledge of accounts receivable is preferred. Ability to communicate and collaborate effectively with external contacts including county financial workers, Department of Human Services help desk, and health insurance companies. Skill in recognizing and implementing new systems that will increase the efficiency of administrative processes and ease the work of the Finance Department. Ability to develop and maintain receptive, open, and approachable lines of communication with clients and staff, and provide a friendly environment for visitors. Strong written and verbal communication skills, including composing, proofreading, and editing. Presentation and meeting facilitation skills. Ability to work as a proactive and positive member of a team to deliver quality services. Ability to maintain confidentiality of organization, personnel information, and client data. Ability to use sound judgment and maintain healthy professional boundaries. Ability to meet deadlines and set priorities. Proficiency with a variety of web-based software and databases, including Microsoft Office Suite, electronic health records systems (Guild uses Credible), electronic health care billing platforms in general, and third-party billing systems. Working Conditions: Work is performed in an office environment with frequent interruptions. Travel may be required to other program sites. Prolonged periods at a desk, working on a computer. Walking and standing continuously for hours at a time. Manual dexterity for tasks such as taking notes and using technological devices for documentation. Must be ambulatory and able to negotiate stairways. The ability to lift and carry heavy weights that could be up to 25 pounds. Education and Experience: Required High school diploma or GED. 1 year of full-time, relevant experience working in medical billing. Preferred Experience using the State of Minnesota website, MN-ITS, the Department of Human Service's billing system for providers enrolled in Minnesota Health Care Programs (MHCP).Prior experience working in collections related to medical billing. Post-high school technical training is desirable.Additional Requirements: Must not be actively receiving services from Guild and must not have received services within the last two years.A valid Class 'D' Driver's License, reliable vehicle, satisfactory driving record and necessary insurance.Guild's Employer PromiseWe know you do your best work when you feel supported and have the flexibility to meet all of life's demands, no matter what those demands might be. Guild is an environment where your emotional, physical, and social wellbeing matters. A place where we're motivated to care for each other and to work together to make a difference in the lives of our clients. We show up for our clients and we show up for each other. And Guild shows up for you.About GuildGuild is a Minnesota not-for-profit 501(c)(3) organization that empowers those living with mental illness and/or experiencing long-term homelessness by helping them find the tools they need to lead stable, fulfilling lives in communities of their choosing.Benefit HighlightsGuild Services offers a range of benefits, including medical, dental, and vision coverage; flexible spending, HSA, short and long-term disability; Paid Time Off; paid holidays; wellness hours; 403(b); life insurance; and more. Eligibility requirements and other terms and conditions apply.The salary range for this position is between $23.00 and $25.00 per hour. The range reflects the minimum and maximum salary for the position. Compensation will depend on the candidate's professional experience, skills, and relevant education, training, and certifications.
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