WHO WE ARE

Within Health has a revolutionary approach to the virtual treatment of eating disorders. We provide clinically continuous care, in the comfort of the clients own home. We provide excellent care 100% virtually and are a 24/7 company to ensure the care for our clients is superior than others.

THE ROLE

The Billing Specialist’s primary responsibility is to oversee the billing process for clients. Ensure timely and accurate submission and processing of client invoices and insurance claims. The Billing Specialist will also research and resolve all provider and client inquiries in a timely and customer-focused manner.

WHAT YOU’LL DO

• The primary function is to take ownership of the error free completion of the entire weekly bill cycle to include:
• Checking eligibility and benefit verification for services provided as needed
• Conduct client and guarantor welcome orientations on the insurance/private pay/balance billing process
• Maintain communication with clients on the billing process, status of their claims
• Manage the status of client accounts and balances and identify inconsistencies
• Create, send and collect on bi-weekly invoices for balance billing and SCA, private pay clients
• Follow up, collect, charge and post large client balances
• Professionally answer and respond to calls, and emails from patients, payers, and other team members re: claims, balances, eligibility, etc., promptly.
• Accurately prepare, review, and submit claims within timely filing to various insurance companies electronically, or in some case via paper using correct revenue, HCPCS, CPT and ICD10 codes
• Post insurance and patient payments from ERA’s or EOB’s within a timely matter.
• Follow-up on open, denied, underpaid, overpaid and non-paid claims and re-submit, send back, appeal as needed
• Write, compile medical records, etc. for appeals, retrospective reviews, authorizations as needed; and follow up accordingly.
• Collaborate with clients and insurance companies, team members to resolve billing inconsistencies and errors.
• Review patient accounts for trends that indicate where additional assistance might be needed.
• Constructively handle patient complaints and report to your supervisor immediately.
• Support billing team as needed when individual tasks are completed, or if help needed to complete a project.
• Monitor your daily, weekly performance and submit daily delegations to billing manager.
• Plan, organize, direct and control to meet all billing objectives.
• Maintain and track your personal calendar, calls, and deadlines.
• Motivate yourself to perform well.
• Communicate potential opportunities for optimization.
• Constantly strive toward continuing professional growth
• Accurate and timely processing of all adjustments (debits and credits), initiated by either external (client-related) or internal (Shared Services) requests
• Timely research and resolution of all billing inquiries to the assigned mailboxes utilizing the highest level of customer service
• Other duties assigned by supervisor