Mental Health Billing and Collections Specialist

2 weeks ago

Canton, United States Pathway Caring for Children Full time
Job DescriptionJob Description

Location: Canton, OH

Job Type: Full Time

About Pathway Caring for Children:

Pathway Caring for Children is a nonprofit organization based in Ohio, United States. They specialize in providing a range of services for children and families in need, including foster care, adoption, mental health services, and behavioral health treatment. The organization is committed to supporting children's well-being and helping them thrive in safe and nurturing environments. They also offer support and resources for families to strengthen relationships and overcome challenges. Overall, Pathway Caring for Children plays a vital role in the community by promoting the welfare of children and families through their comprehensive programs and services.

Qualifications:

The successful applicant for this position must possess the following qualifications:

Education or Experience:

At least two years of post-secondary education or equivalent work experience (5 years or more) in medical billing, customer service, and/or collections.

Skills and Abilities:

  • Ability to multitask, prioritize tasks, and meet required timelines.
  • Proficiency in general office practices, organizational skills, and competence in Microsoft Office Programs.
  • Effective communication skills with sensitivity and consideration for the cultural differences among the children and families served by Pathway.
  • Working knowledge of ICD-10 coding, CPT, HCPCS, EOBs, ERAs, and medical terminology.
  • Experience in Commercial and Medicaid billing related to mental health services is preferred.
  • Excellent understanding of the medical billing process.

Other Requirements:

  • Possession of a valid driver's license with a good driving record.
  • Must have automobile liability insurance and access to a safely maintained car.

Responsibilities:

The Mental Health Billing & Collections Specialist will report to the Accounting & Billing Supervisor and work from the Central Office of Pathway. Responsibilities include:

  • Claims Submission:
    • Generate Weekly Incomplete Service Notes Report.
    • Assist in appropriate claims coding.
    • Collect all information necessary to prepare insurance claims and bill patients.
    • Run Agency monthly eligibility.
    • Verify accuracy of client billing data and revise errors prior to submitting to plans.
    • Obtain and/or enter documents such as authorizations, financial agreements, and other necessary ancillary documents.
    • Process the claim production report several times a week to force any claims that have been stopped.
    • Process weekly and monthly billing in absence of Accounting and Billing Supervisor.
  • Billing:
    • Utilize CPT coding, ICD coding, and HCPCS in relation to mental health services medical terminology.
    • Enter and update billing data into the electronic health record.
    • Process all Mental Health Client billing.
    • Generate report to post unbilled claims at month-end.
    • Verify claims received by insurance companies.
    • Review all payer rejects and correct rejected claims in clearing house and other insurance websites.
  • Payment Posting:
    • Review and process (post) EOBs/ERAs.
    • Research, correct, and re-submit rejected and denied claims.
    • Prepare claim appeals.
    • Process credit card payments from clients and payments received from other offices through an online processing site.
    • Minimize claim denials to maximize revenue.
    • Understand copays, coinsurance, and deductibles.
    • Resolve discrepancies in accounting records.
  • Collections:
    • Call to collect on client collection accounts.
    • Provide the Controller and billing team with a monthly MH AR Aging report.
    • Monitor aging reports and take necessary steps to guarantee payment of claims.
    • Interact with staff, clients, payer, and agencies to answer questions, obtain information, and resolve issues.
    • Recognize problem accounts and notify appropriate staff or supervisor for assistance.
    • Update and send information to the Collections Attorney.
    • Attend collection hearings as a Pathway representative.
  • General Responsibilities:
    • Assist Accounting & Billing Supervisor as needed.
    • Maintain detailed records as required.
    • Participate in billing auditing processes.
    • Provide feedback for improved claims processes and performance, reduce errors, and improve quality assurance.
    • Communicate and send reports to Enrollment, Clinicians, Therapist, and Directors.
    • Work closely with the Controller to provide month-end reports.
    • Anticipate insurance trends and advise supervisor of changes.
    • Attend bi-weekly MH Billing Meetings and be prepared to discuss any trends, updates, reports, collections, and judgments.
  • Other:
    • Participate in in-service training designed to improve job knowledge or performance.
    • Assist with providing coverage for the front desk.
    • Attend regular team and supervision meetings with supervisor.
    • Undertake special projects assigned by supervisor.

How to Apply:

Update your resume to reflect your relevant education, work experience, skills, and qualifications outlined in the job posting. Write a cover letter expressing your interest in the position and highlighting how your experience and skills make you a suitable candidate.



Pathway is a smoke free and drug free organization. All applicants must be able to pass a background check.



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