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Medical Billing Specialist Lead
2 months ago
Since 1972, Therapeutic Health Services (THS) has provided evidence-based, culturally appropriate and compassionate behavioral health treatment, programs and services for children, youth, and families with substance use and mental health disorders. We are on the frontlines:
- Fighting the region’s opioid epidemic
- Providing behavioral health support for those experiencing homelessness
- Lowering barriers to behavioral health for youth and adults who have had challenges accessing quality care
- Specialists in serving the needs of the BIPOC and LGBTQIA communities
- A family of caring and compassionate providers dedicated to serving the most vulnerable in our community
We are hiring a Medical Billing Specialist Lead to join our Seattle Team. As the Medical Billing Specialist Lead, you will spearhead the timely submission of accurate claims to insurance carriers and lead a dedicated team in resolving denials. Your role is pivotal in optimizing revenue generation and ensuring maximum reimbursement efficiency. The pay for this position is $26.00- $32.00 an hour.
Requirements:- Denial Management: Analyze, address, and resolve denials received from payors. Conduct root cause analysis and implement corrective actions to minimize future denials.
- Appeals Processing: Conduct thorough appeals processes, including preparing necessary documentation, submitting appeals, and following up with payors to ensure successful resolution.
- Claims Submission: Ensure clean insurance claims are sent to carriers in a timely manner. Resolve carrier responses for provided services.
- Claim Resolution: Process inaccurately paid accounts by contacting payers, processing correspondence, rebilling, and conducting appeals to achieve the highest possible reimbursement.
- Coding Corrections: Correct CPT and ICD-10 codes. Conduct batch research and submit dictionary updates (HCPCS).
- Communication: Effectively communicate with insurance carriers/payors, the Billing team, and both internal and external customers via phone and written correspondence to resolve denials and payment issues.
- Account Reconciliation: Follow up and reconcile both credit and debit accounts to ensure accurate and complete records.
- Audit and Compliance: Audit records and claims submissions to identify discrepancies. Perform appeals when necessary and ensure compliance with regulations.
- Trend Reporting: Conduct trend reporting and present findings to management to implement measures meant to reduce denial rates.
- Additional Responsibilities:
- Support other specialists and be the subject matter expert on claim denials.
- Provide coverage for other team members as needed.
- Perform other duties assigned by the Billing and Revenue Manager and CFO.
MINIMUM REQUIREMENTS:
- High School Diploma or Equivalent
- Proven experience in medical billing and denial management.
- Strong understanding of CPT, ICD-10, and HCPCS coding.
- Excellent analytical and problem-solving skills.
- Effective communication skills, both written and verbal.
- Ability to work independently and lead a team.
- Attention to detail and strong organizational skills.
- Knowledge of compliance regulations and audit processes.
We offers the following benefits to full and some part-time staff:
- Employer paid medical/dental/vision insurance packages.
- Employer paid life insurance
- 12 accrued vacation days for year one, up to 20 days in subsequent years
- 12 days sick leave accrual per year
- Mental Health Day
- 1 Personal Day
- 12 Paid Holidays
- Flexible Spending Plan
- 403(b) Retirement plan
- Employee Assistance Program
- Training Allowance/License Reimbursement
- We are also a Second Chance Employer
