Job Description

Job Description – Medical Billing Specialist -

Join us in our exciting downtown Denver office for a new opportunity. We are seeking a Medical Billing Specialist to assist with our patient financials. White glove service and unscrupulous integrity is a must for this position. This position will start in our office 5 days per week for the first three months, with a possibility to transition to a hybrid model of 3 days in the office and 2 from home after the first three months. Prior healthcare billing experience is required along with behavioral health experience, if possible. This position comes with a full benefit package including a 4% matching 401K and free parking!

Position: Medical Billing Specialist

Reports to: Controller

Location: Denver Office

Schedule: FT, 40 hours per week, M-F 8am-5pm – In office first three months. 3 days in office/2 days at home Hybrid possible after 3 months.

Overview: Gallus is a growth-oriented, customer-focused company that seeks to improve access to care for individuals struggling with substance use disorders. The Medical Billing Specialist will serve as a connector between the admissions team, where individuals begin their patient journey at Gallus, the full-service insurance billing company vendor in place and the finance department. A solid background in medical billing, excellent patient service skills and in-depth working knowledge of insurance is essential for success in this role.

Responsibilities:

• Pre-authorizations and Verification of Benefits: Work with admissions staff to ensure appropriate collections of co-pays, deductibles and/or self-pay fees. Candidates should have experience reading verification of benefits reports and working with or for a medical billing company internal function. Ensure that the clinical teams at each facility complete pre-certifications and utilization reviews so insurance authorizes services without delays.
• Patient Communication: Evaluate and communicate patient financial responsibility based on insurance verification data and medical cost estimates. Collect payments for additional services, extended stays or amounts not covered by insurance. Handle all patient billing questions and concerns. Obtain additional information needed from patients as necessary.
• Coding and Medical Record Completion: Working knowledge of all coding rules and the ability to implement CPT and ICD codes and appropriate use of modifiers as the company expands into additional treatment services.
• Billing: Follow up and administration of patient fee agreements and resolution of changes in length of stay. Liaison to the billing company in assisting with their timely and complete claim processing. Main point of contact with patients to resolve questions they have about cost of treatment.
• Accounts Receivable and Collections: Post payments, adjustments, and refunds accurately. Process insurance correspondence that is sent to corporate office and assist billing company with investigation of denied claims and related appeal processes. Reconcile patient accounts after all insurance claims process to determine necessary refunds or balance billing. Submit accounts to collections agency when necessary. Communicate with patients and guarantors to clarify billing issues and resolve payment issues.
• Reporting: Review reporting from billing company to reconcile internal insurance A/R, find trends in reimbursement rates and days to pay by insurance company, etc.

Skills/Minimum Requirements:

• Knowledge and experience in behavioral health (preferred)
• Knowledge of KIPU or other EMR/CRM systems (preferred)
• Experience with Collaborate MD (preferred)
• Attention to detail, superior organizational skills, and critical thinking ability
• Ability to maintain patient confidentiality and information security and adhere to HIPAA guidelines and regulations
• Function as a contributing team member while meeting deadlines and productivity standards
• Commitment to excellent patient customer service while maintaining the highest degree of professionalism
• Associate’s Degree required, Bachelor’s Degree preferred
• Exceptional MS Office experience required
• 3-5 years’ experience as a medical biller with excellent record of collections
• Working knowledge of CPT and ICD-10 coding systems; coding certification preferred but not required
• 3 years of experience in a customer experience role

Compensation: $60,000-$70,000 per year

Gallus Medical Detox Centers’ Mission: Gallus Medical Detox is a growth oriented, customer focused company that seeks to improve access to care for individuals struggling with substance use disorders. The Company provides the highest quality inpatient medical detox services using proprietary, evidence-based IV therapy and oral medication protocols that avoid cross addiction, delivered by highly trained medical staff, in a safe and comfortable patient environment that optimizes treatment outcomes. Our vision is to be the best, first step in overcoming substance use disorders for patients needing medical detox; to be nationally recognized as a Center of Excellence for medical detoxification services, leading the field in the science, professional education, staff training and customer experience.

GMDC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Job Type: Full-time

Pay: $60,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• Denver, CO 80203: Reliably commute or planning to relocate before starting work (Required)

Education:

• Associate (Preferred)

Experience:

• ICD-10: 1 year (Preferred)
• CPT coding: 1 year (Required)
• Patient Financial Account Management: 1 year (Preferred)

Work Location: Hybrid remote in Denver, CO 80203

• Health insurance

Similar Jobs