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Behavioral Health Billing Specialist

POSITION DESCRIPTION

The Behavioral Health Billing Specialist is responsible for timely and accurate submission of claims to insurance companies and Medicaid, A/R follow-up, review of client accounts by utilizing billing practices that are ethical and compliant with government and contract regulations.  This individual will perform a variety of billing and follow-up duties along with customer service to our clients.

RESPONSIBILITIES
 

  • Submit, review and resolve all unpaid client and insurance accounts.  Includes, but is not limited to:

    • Prepare and submit claims either electronically via Credible EHR and the Clearinghouse or on paper via mail.

    • Review and correct claim errors at the Clearinghouse and Credible level.

    • Resolve claim issues and resubmit corrected claims or reconsideration requests.

    • Provide timely follow-up for claims and claim denials to ensure maximum reimbursement for services provided and submit appeals to insurers, as necessary.

    • Excellent phone etiquette when dealing with client and insurance inquiries.

  • Research, audit, and investigate proper payment of claims and client accounts.

  • Prepare and send out monthly statements to clients.

    • Contact clients for payment resolution and negotiate payment plan arrangements.

  • Serve as point of contact for patient billing questions.

  • Provide support to Finance and Management as needed.

  • Attend regularly scheduled staff meetings.

  • Demonstrates a high degree of skill in communication and positive interaction with all employees, prospective employees, external agencies/companies, and the community at large.

  • Perform all other duties as assigned.

ESSENTIAL JOB REQUIREMENTS
 

  • Ability to exercise discretion and maintain both client and employee confidentiality in accordance with HIPAA, contract requirements, or other applicable laws and regulations.

  • Ability to professionally interact with all levels of organization.

  • Minimum of 2 years of medical billing experience or similar role.

  • A certificate or degree in medical insurance and billing is preferred, but not required.

  • Strong understanding of behavior health and medical billing, as well as medical terminology.

  • Strong working knowledge of insurance guidelines and reimbursement process for medical and mental health billing.

  • Understanding of Revenue Cycle Management process.

  • Excellent skills in analyzing, interpreting, and occasionally, posting EOBs.

  • Understands authorizations and limits to coverage.

  • Solid understanding of Credible billing software and electronic health records. (preferred)

  • Working experience with clearinghouse processes.

  • Effective written and verbal communication skills.

  • Can do teamwork attitude and the ability to remain calm under pressure.

  • Must have the ability to multitask and manage time effectively.

  • Outstanding problem-solving and organizational abilities.

  • Certification in billing preferred, not required.

  • Ability to perform a range of physical motions including but not limited to:

    • Standing, walking, sitting for long periods of time

    • Ability to use required equipment:

    • Telephone – frequently

    • Copier – occasionally

AGENCY COMMITTMENTS

  • Commitment to the Mission, Vision, and Values of the agency.

  • Accept and positively engage with people with a variety of lifestyles, behaviors, cultural and spiritual practices and ability statuses.

  • Effectively manage own work while working within a team environment.

  • Adapt and respond effectively to change.

PAY: $22.90 - $28.70 per hour

BENEFITS
Full and part-time employees at Ryther enjoy a variety of competitive benefits including: 
 

  • Comprehensive Medical and Dental Coverage (We pay your medical deductible!)

  • Multiple Retirement Plan Options (403b tax deferred)

  • Generous Paid Leave Program (3 weeks paid vacation, 10 accrued sick days, 5 personal days, and paid holidays)

  • Life Insurance Coverage

  • Professional development funds

  • Ryther is a recognized and accredited non-profit (501c3) which qualifies for the federal public student loan forgiveness program

SUPERVISOR: Billing Manager

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