Medical Billing & Benefits Specialist

Role Description

The Billing & Benefits Specialist is a critical element of the Skyway mission, which is to ensure that all team members, even those not providing direct clinical care, know and believe they can change and improve patient’s lives. When serving with integrity and in alignment with the Skyway Mission, we create a reverberating positive impact on the patients.

  Essential Functions/Core Responsibilities  

• Responsible for the accurate, timely submission of CMS1500 and UB-04 claim forms.
• Maximize accurate reimbursement with the goal of reducing reoccurring billing and collection errors and improving the clean claim pass rate.
• Treats client with respect and maintains confidentiality.
• Resolution of all delinquent patient accounts, per guidelines, to secure payment.
• Answers the telephone professionally and in a timely manner; directs calls appropriately.
• Payment posting (ERA and manual posting).
• Establishing payment arrangements per company policy
• Provides input to the revenue cycle management to identify and correct issues preventing clean claim submission.
• Interact with internal and external resources to resolve billing inquires and claims discrepancies.
• Orders itemized bills for patients and insurance companies when requested.
• Generate and reconcile reports.
• Demonstrates a good working relationship within the department and with other departments.
• Demonstrates the ability to be flexible and organized.
• Maintain completion of all competencies associated with the role and in accordance with Skyway Behavioral Health policies and subsequent Joint Commission standards.
• Supports the organization's mission, vision, values, and strategic in initiatives. Develops, implements, and improves processes to ensure that established policies, goals, and objectives are achieved.
• Ensures compliance with all applicable local, state, and federal regulations and guidelines.
• Must have strong attention to detail, investigational and problem-solving skills.
• Must have a positive attitude and ability to work independently and within a team.
• Perform other duties as assigned.

Minimum Requirements

• 2 or more years of experience in a clinical or medical setting.
• Proficient (preferably in behavioral health) and billing terminology.
• Basic understanding of CPT, HCPCS, modifiers, ICD 10
• Have an understanding of HIPAA regulations.
• High school/GED or higher, medical billing/coding training/certification or equivalent experience.
• Exceptional organization skills, reliable and timely.
• Excellent interpersonal and communication skills that are clear, respectful, and considerate of others’ perspectives.
• Must be fluent in reading, writing, and speaking English.
• Strong computer skills, able to quickly learn billing software.
• Ability to work on a computer for extended periods of time.
• Reliable form of transportation to work.
• Proficiency in Microsoft products (Teams, Word, Outlook, Excel),
• Familiarity with the use of EMR systems and payer portals.
• Ability to multitask.

Additional Preferred Skills

• IOP/PHP billing knowledge and experience with BCBS UPP payments
• A passion for coaching, mentorship, and team development.
• A problem-solving orientation and eagerness to identify process gaps and implement practical solutions.
• Ability to work independently as needed, recognizes the need for support, and demonstrate the willingness to ask for help.
• Ability to manage multiple priorities and respond with confidence during challenging or chaotic situations.
• Someone who embodies Skyway values:
  • Embraces the whole person.
  • Commits to innovative research-based programs.
  • Believes we are better together.
  • Celebrates expressions of diversity.
  • Believes in service and supporting our communities.
  • Views leadership as a privilege to elevate others to their highest potential.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee frequently is required to stand; use hands to finger, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; and taste or smell. The employee is occasionally required to walk and climb or balance. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

Benefits:

• Medical benefits- Blue Cross Blue Shield of Illinois
• Dental benefits- Blue Cross Blue Shield of Illinois
• Vision benefits- Blue Cross Blue Shield of Illinois
• Short & Long Term Disability
• 401K Safe Harbor Match
• PTO
• Paid Holidays
• Paid Floating Holidays
• Paid Wellness/Self-Care Days
• Paid sick time
• Collaborative professional growth development

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally exposed to wet and/or humid conditions and outside weather conditions. The noise level in the work environment is usually moderate. Work hours may vary in this leadership role and may require responding to phone calls from direct reports during off hours.

Skyway Behavioral Health is proud to be an Equal Opportunity Employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. 

We celebrate diversity and are committed to creating an inclusive environment for all employees.