Billing Specialist 1

Who We Are

Backpack Healthcare walks around with an invisible backpack. It carries our emotional experiences, traumas, and unresolved feelings. Similar to a physical backpack, it can become heavy and burdensome when filled with too many items we created Backpack Healthcare to help lighten the load. We are re?imagining mental health care for children, teens, and young adults. As a clinician?led, minority?owned company, our mission is simple : when clinicians thrive, kids thrive.

Were offering not just a job but purpose, flexibility, and the chance to change lives every day. If youre ready to be part of a collaborative, empowering, and innovative mental health movement, join our team and make a real impact by breaking barriers and healing young minds.

Position Summary

The Billing Specialist 1 is responsible for managing payor accounts with outstanding balances, ensuring accurate balances and timely collection of payments while maintaining a professional and compassionate approach. This role requires a strong understanding of insurance claims, payment posting, and patient billing processes to effectively resolve balances and reduce accounts receivable.

As a Billing Specialist 1, you are expected to follow the Standard Operating Procedure (SOP) outlined for patient accounts specialists, as follows :

Essential Job Functions

Scope of Responsibilities

Obtaining Missing Insurance Information

• Proactively communicate with patients via phone, email, or text to gather necessary insurance information that is incomplete or missing.

Verification of Benefits

• Accurately verify patient benefits and eligibility using Waystar, Availity, or through insurance provider portal. This includes confirming network participation, mental health coverage, and any prior authorization requirements.
• If needed, directly contact insurance providers via phone to obtain vital information, documenting details in the patients chart log.

Addressing Patient Balance Inquiries

• Respond professionally to incoming patient calls using the prescribed greeting.
• Assist patients by providing information on :
• Balance totals
• Dates of services related to outstanding balances
• Explanation of balance (copay, coinsurance, deductible)
• Technical issues related to Healow Pay
• Processing payments via phone and providing copies of previous statements and receipts.

Billing Disputes

• Identify disputes that cannot be resolved at your level and successfully transfer these to the designated third?party billing vendor.

Assigned Departmental Projects

• Participate in departmental projects as assigned, which may include :
• Implementation of new billing software or updated processes to enhance efficiency.
• Training sessions for new hires or ongoing training for current employees.
• Collaborative initiatives to improve patient billing communication or decrease outstanding patient balances.
• Quality assurance audits of billing procedures and patient interactions.
• Actively collect and analyze customer feedback continuously to enhance tools and processes. Collaborate with other teams to improve the overall customer experience.
• Proactively identify opportunities to enhance the customer experience through support and mitigate churn risks.

Performance Metrics

• Response Time : Maintain a response time of less than 24 hours for obtaining missing insurance information.
• Hold Time During Call : Should not be more than 3 minutes without providing an update to the patient.
• Accuracy Rate : Achieve an accuracy rate of 98% or higher in verifying patient benefits.
• Patient Satisfaction : Facilitate a positive patient experience with a satisfaction score of at least 90% based on feedback surveys.
• Volume of Inquiries : Handle 100% of patient phone inquiries during business hours while ensuring quality responses.
• Project Participation : Actively contribute to at least one departmental project per quarter if applicable, providing updates on progress and outcomes.
• Escalation Rate : Maintain an escalation rate below 5% of total tickets.

Preferred Qualifications

Soft Skills

• Strong technical acumen with the ability to quickly learn and master new software
• Excellent communication skills, capable of handling complex customer inquiries and providing clear, effective solutions, using email, phone, and text
• Demonstrated ability to work collaboratively with cross?functional teams
• Deeply cares about customer interactions, the voice of the customer and understands how customers can elevate the brand
• Results and data?driven mentality, with a bias for speed and action
• Thrives in the ever?changing world of a fast?growing company

Hard Skills

• 3+ years experience in Customer Support, Customer Success, Account Management, Relationship Management, preferably in a technology or health?related industry
• Google Suite and Microsoft 365 proficiency
• Excel and Dashboard Reporting
• NiceIncontact, eClinicalworks, Waystar, Availity experience preferred
• Strong attention to detail
• Data Entry

Backpack Health is an Equal Opportunity Employer. We believe that the strength of our care depends on the diversity and wellbeing of our team. We celebrate differences in age, color, disability, ethnicity, gender identity or expression, national origin, physical and mental ability, race, religion, sexual orientation, veteran status, and other traits that make each person unique. We welcome and encourage diverse candidates to apply for any position for which they are qualified and to bring their unique perspectives, experiences, and talents to our team.

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