Billing and Scheduling Specialist For Adults with Disabilities

Job Overview

As a Billing and Scheduling Specialist, you will be responsible for managing all billing and scheduling activities. Your primary duties will include accurately processing invoices, handling insurance claims, and scheduling client visits. This position requires strong attention to detail, organizational skills, and the ability to handle multiple tasks efficiently.

Key Responsibilities

Billing:

• Prepare and process invoices for services rendered, ensuring accuracy and compliance with billing protocols.
• Review and verify billing data, including insurance details and service codes, to ensure completeness.
• Submit insurance claims and follow up to resolve any discrepancies or rejections.
• Manage payments, track outstanding invoices, and apply refunds or adjustments when necessary.
• Maintain updated knowledge of billing procedures, coding standards, and insurance guidelines.
• Respond to billing inquiries from clients, case managers (Support Coordinators) or colleagues in a professional and timely manner.
• Communicate with families & Support Coordinators as needed to resolve billing issues.

Scheduling:

• Connect with new clients to introduce yourself and your role, and assist in setting up their initial schedule.
• Follow up on missed clock-ins or clock-outs by contacting caregivers to identify and resolve any issues.
• Review the preset schedule for errors and make necessary corrections to ensure accuracy and efficiency.
• Schedule services to maximize hours by aligning caregiver availability with client needs, ensuring optimal scheduling that minimizes uncaptured hours and avoids scheduling conflicts.
• Maintain and update appointment calendars, handling cancellations and rescheduling.
• Communicate with clients and caregiver to confirm appointments, including reminders and rescheduling.
• Communicate proactively with colleagues regarding scheduling challenges, such as shortages of available Life Skills Mentors, frequent client schedule changes, or underutilization of caregiver that may indicate a need for additional hiring.
• Coordinate schedules between departments, providers, and clients to ensure smooth operation.
• Ensuring the schedule is accurate and reflects prior authorizations.

Customer Service:

• Provide excellent customer service to clients or patients by addressing concerns or questions related to billing or appointments.
• Resolve any scheduling conflicts or issues while maintaining a high level of professionalism.
• Educate clients on payment policies, billing procedures, and appointment requirements.
• Proactively communicate with team members to ensure adherence to company procedures and excellent customer service.
• Support efforts to enhance company culture by informing relevant team members of upcoming client and caregiver birthdays, work anniversaries, and important milestones, enabling timely recognition and engagement.
• Promote company services through networking, marketing, events, etc.
• Participates in on-call rotation as assigned.

Record Keeping & Reporting:

• Keep accurate and organized records for billing and scheduling, ensuring they are readily accessible for review or audits.
• Assist with generating billing and scheduling reports as needed for management or financial tracking.
• Ensure compliance with company policies, privacy regulations, and industry standards for billing and scheduling processes.
• Maintain company records and organizational systems.

Team

• Reports to: Program Director
• Collaborates with: Client Success Manager

Must be able to communicate fluently and effectively in English, both verbally and in writing, to ensure clear and professional interactions with clients, caregivers, and colleagues.