This position is responsible for accurate submission, tracking and posting of mental health and multi-specialty medical facility provider claims. The individual will work with our EHR to input, monitor and follow up claims status. The position must be highly proficient and accurate in performing patient insurance verifications and determining which insurance is primary. This position will be responsible for managing the appeals process and working with the insurance companies for claims resolutions. They will oversee and execute credentialing and contracting for providers with insurance and/or EAP companies and assist with ongoing requirements to maintain contracts. They will assist in enhancing our billing process through continuing research and identification of new and existing billing codes and techniques. The position will work closely with finance, accounting, and the insurance companies to identify best practices for billing that maximum reimbursement for the agency.
Assignments/tasks are expected to be executed with considerable independence, must possess outstanding attention to deal and maintain compliance with established facility policies and procedures, contract requirements, organization bylaws, and federal and state regulations/laws.
To succeed in this role, you must possess in-depth knowledge of mental health billing and prior experience using practice management software. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as communicating with providers, clients and various insurance agents will form a large part of the job. Effective analytical skills to problem solve problems as they arise is necessary. This position will be responsible for all aspects of patient/client billing/coding and collections, including but not limited to performing the billing function, ensuring timely payment, collections and follow-up. This position will recommend, provide input and may develop policies, processes and resources to evaluate and improve the billing and accounts receivable collection effectiveness and efficiency for the agency.
- Insurance Eligibility & Benefit Verification: Our Medical Biller/Insurance Specialist will verify all new clients’ insurance eligibility and benefits and input applicable insurance and insurance verification information into our medical records system. Iowa Medicaid/state insurance plans will be verified monthly to ensure the client’s continued eligibility for insurance coverage.
- Claim Submission: Our Medical Biller/Insurance Specialist electronically submit our claims to insurance companies for reimbursement via our electronic health record and practice management software and/or insurance portals as needed. Our Medical Biller/Insurance Specialist will be responsible for following up on claim submissions, managing claim/payment appeals, denials, and mis-adjudicated claims, as well as auditing in preparation for billing, ensuring providers are providing timely and accurate documentation for billing and related insurance requirements. Must remain up to date on current contracted rates of pay, changes in CPT codes, and requirements for claims submission
- Client Balances: Our Medical Biller/Insurance Specialist will be responsible for the detailed monitoring of copays, deductibles, and payments. Ensuring client balances in our electronic health records and practice management software are up to date and in real-time. Ensuring clients have active credit card payment authorizations on record. Answering all client inquiries about their insurance coverage and/or account balance.
- Invoices: Invoices will be generated monthly, reviewed and approved on-site, and mailed to financially responsible parties.
- Financial Reports: Provide Director with daily payment posting and billing reports. Review accounts receivable on a monthly basis and follow up on outstanding client balances. Assist with generating auditing and aging reports. Assist with quarterly and annual report preparation as needed.
- Credentialing: Managing and overseeing contracting and credentialing with insurance companies and 3rd party payors.
- Other Duties as assigned
- Possess an Associate's degree from an accredited college or university with a major in Accounting, Health Administration, Medical Records Administration, Coding/Medical Billing, or closely related field; AND Have a minimum of three (3) years work experience in medical or behavioral health setting.
- Possess a Certified Professional Coder (CPC) Certificate or a Certified Coding Specialist (CCS) Certificate.
- Experience in CAQH and insurance credentialing is preferred.
$18 - $22 hourly
About InJoy Counseling
We are a team of dedicated counselors and support staff who walk hand in hand with people as they reclaim inner joy, peace and wholeness.