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Role serves as point person for client accounts and manages the full revenue cycle, including clean claim submission, denial/denial follow-up, charge error resolution, utilization review, cash application, accounts receivable tracking, and month-end reporting. 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Out life-changing programmatic work includes traumafocused mental health services, domestic violence interventions, supervised visitation, housing stabilization services, homeless engagement, and financial counseling. ([tfsnc.org](tfsnc.org)) The ideal candidate will thrive in a fast-paced, teamoriented work environment with the ability to operate independently to achieve results.  \nEssential Job Function – Act as point person for all client accounts and the revenue cycle  \nQualifications:  \n• Bachelor’s degree preferred  \n• Previous billing experience with licensed therapists, primary care, maternal health and or lactation services  \n• Certification as a biller preferred or specific training as such  \nKnowledge, Skills and Abilities: Excellent communicator. Able to solve problems with a high level of attention to detail. Able to analyze billing and financial statements. The knowledge and ability to effectively manage through the revenue cycle.  \nResponsibilities:  \n1. Billing and Front Office Duties:  \n• Review daily appointment log and charts for appointments as to any insurance payment issues and order chart completeness, if necessary to complete billing processes.  \n• Ensure all claims are clean prior to sending them out to the third-party payor.  \nActively work denials by following up with clinical staff as needed to ensure corrected claims.  \n• Review, account and reconcile fee-for-service transactions received from both insurance companies and clients to encompass all accounts receivable charges and payments.  \n• Maintain a sliding scale and payment plan arrangement list for all necessary departments.  \n• Review and maintain utilization review by communicating with clinicians for authorization justification and frequency limits and requesting authorizations weekly and as needed.  \n• Review and work through clearinghouse rejections and denials.  \n• Review Pending Charge Error reports and resolve errors. Communicate with clinicians if resolution is needed on their end.  \n• Review Charge Generation weekly for errors and adjustments that are needed.  \n• Run the Service Activity Analysis weekly and monthly for productivity calculations and forecasting.  \n• Review for incomplete documentation and send to the clinicians twice a week for follow up, and before month end closing; also, to be included in productivity calculations.  \n• Run the Late Billing report to include in productivity calculations and provide to Clinical Director for escalation.  \n• Review discharges and balances past one year for write off consideration.  \n• Review outstanding insurance charges past 45 days with no insurance correspondence for rebill opportunities.  \n• Review and resolve claim denials.  \n• Stay up-to-date on insurance policies and billing procedures, to include Alliance All Provider Meetings.  \n• Meet at least once a month with the billing agency to review system or billing concerns.  \n• Complete account allowances include contractual adjustments, sliding scale fees, and write offs.  \n• Add non-ucr charges and ensure they are accurate.  \n• Complete receipt entries and maintain unapplied cash; to be reconciled by Month End.  \n• Month End completion and reporting; to include pending activity, cash analysis, charge analysis, allowance analysis, and accounts receivable prior and current reporting, programmatic reporting.  \n• Troubleshoot EHR and maintain billing rules, and payor, organization and activity maintenance  \n2. Pre-certification/Authorization  \n• Obtain all pre-certification and authorizations prior to first visit and as needed during care and with any change.  \n• Obtain all pre-certifications and authorizati","cbCaihkR066XTbjc","https://ap.wps.com/l/cbCaihkR066XTbjc","pdf",132799,"English","# Position Overview\n## Essential Job Function\n# Qualifications and Skills\n# Responsibilities\n## Billing and Front Office Duties\n## Pre-certification/Authorization\n## Cash Application\n## Accounts\n## Team and Additional Duties\n# DOSE Program\n## Apricot Reconciliation and Reporting\n# Work Schedule and Compensation","[{\"question\":\"What is the essential job function of the Medical Billing Specialist?\",\"answer\":\"Act as the point person for all client accounts and manage the revenue cycle to drive results in a team-oriented environment.\"},{\"question\":\"Which billing responsibilities does the role include?\",\"answer\":\"Review appointments and charts for insurance payment and documentation completeness, ensure claims are clean before submitting, work denials and denials/clearinghouse rejections, resolve pending charge errors, and run billing and service activity analyses for productivity and forecasting.\"},{\"question\":\"What does the job require for authorization and cash application?\",\"answer\":\"Obtain all pre-certifications and authorizations before and during care as needed, and review encounters and clinician logs to ensure missed forms or additional billing are addressed. Cash application includes reconciling deposit reporting in Apricot and maintaining unapplied cash for Month End reconciliation.\"}]","Medical Billing Specialist - Job Description - Finance (Reports to CFO) | PDF",1789325713]