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Medical Claims Specialist
4 months ago
We are seeking self-motived high achievers to join our team. Bright Futures Psychiatry is 100% PMHNP owned (Female, Air Force Veteran). We are nestled in a gorgeous building by the Broadmoor Hotel area of Southern Colorado Springs.
Our goal is to remove all barriers and worries from our providers so they can focus on delivering high-quality mental healthcare in a timely fashion. At Bright Futures Psychiatry you will find a sense of belonging that promotes collaboration between our providers and our various support teams. Our company culture is one of warmth and inclusivity to both staff and clients.
The Medical Claims Specialist plays a vital role in the day-to-day operations of Bright Futures Psychiatry. They are responsible for managing and submitting 100% of claims generated on a daily basis while maintaining a high degree of accuracy. Medical Claims Specialists also provide continuous feedback to our providers with regards to accuracy of documentation as it related to what is being billed out on claims to ensure we remain within compliance.
DUTIES AND RESPONSIBILITIES
- Working knowledge of most up to date changes in ICD-10, CPT, and other regulatory manuals
- Establishing and maintaining a positive working relationship with clients, payers, and team members
- Processes insurance claims for reimbursement
- Reviews claims data to ensure assigned codes meet current legal and insurance rules
- Audits progress notes and provides feedback to providers and leadership
- Actively manages various worklists as assigned
- Communicates timely filing feedback to assigned providers
- Maintains complete and accurate medical billing/coding record
- Updates and verifies insurance carrier information in the E.H.R.
- Work with clients to develop self-pay payment plans, and ensure compliance
- Enters charges accurately and timely to ensure proper records handling and shortened payment responses
- Process and follow up on payer denials or partial payments in a timely fashion
- Accurately posts payments in timely manner
- Initiates private pay collections after insurance cancellation, denial, or partial payment
- Research and resolve client billing problems as they arise
- Document payment records and issues as they occur
- Responsible for prior authorization for client care
- Provides analysis within related data
- Maintains the 120 days in A/R bucket at or below 5%
- Other duties as assigned
QUALIFICATIONS
- Certified Professional Coder (CPC), preferred
- Medical Billing and Coding: 1 year experience minimum, required
- Previous mental health working knowledge ++
- Working knowledge of E.H.R.s
- High school or equivalent, required
BENEFITS
- Pay range: $19.01 - $21.55 hourly rate
- Bright Futures Psychiatry pays 100% of your Medical, Dental, and Vision monthly premiums.
- 401k + 5% Match
- Student Loan Repayment Assistance Program
- Paid Holidays + Birthday Holiday
- Opportunity to earn Monthly Bonuses
REASON YOU SHOULD WANT TO WORK WITH BRIGHT FUTURES PSYCHIATRY: We treat every member of our organization with respect and support one another as valuable teammates. We continue to grow because the need for mental health services has not been met yet in Colorado... we aim to meet this need. If you are interested in being part of a team that is actually making a difference in Colorado, you should apply.
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