Billing and Collections Specialist

3 weeks ago

Elizabeth, United States Forge Health Full time

**About Us**:
Forge Health is a mission-driven outpatient mental health and substance use provider dedicated to providing the highest quality, affordable, and effective "one-stop-shop" care to individuals, families, and communities in need. As the first and only behavioral healthcare provider with a proven, national payer-validated ability to drive clinical outcomes that span all areas of health, Forge Health is leading the charge in driving innovation, improving care delivery, and shaping the future of behavioral health care.

For the third consecutive year, were thrilled to share that Forge Health has been recognized on the prestigious Inc. 5000 list of the fastest-growing private companies in America
- a remarkable honor that is a testament to our team's relentless commitment to our mission. If you're passionate about building a great business that makes a difference and working alongside sharp, dedicated, and entrepreneurial individuals, then Forge Health is the right fit for you. Come join us

**Who we're looking for**:
We are looking for a Billing and Collections Specialist to join our Corporate team. The Billing and Collections Specialist is a key member of our team and will assist in coordinating the billing and collection operations for Forge Health's facilities across New York, New Jersey, Pennsylvania, New Hampshire and Massachusetts. You are responsible for working with the Director of Revenue Cycle Management to ensure the following is completed in a timely manner: billing insurance companies for all billable procedures, pursuing collection of all claims until payment is made by insurance companies, and performing other work associated with the billing process (e.g. payment posting, denials). You will also perform critical billing functions including but not limited to eligibility verification and denial management to maximize revenue collections.

This position can be performed remotely, and reports into our Director of Revenue Cycle Management.

**What you'll be doing**:

- Performs insurance verification of benefits in a timely and efficient manner.
- Obtains, tracks, and updates pre-certifications and authorizations per insurance carriers.
- Prepares and submits clean claims electronically to various insurance carriers.
- Monitor and correct clearing house and payer claims rejections.
- Obtains, tracks, and updates pre-certifications and authorizations per insurance carriers.
- Follow-up and resolves outstanding receivables utilizing remittance reports and/or explanation of benefits (EOBs).
- Identify and resolve insurance claim denials and submits appeals.
- Ensures patient statement are sent accurately and promptly.
- Post insurance and patient patients based on daily deposits received.
- Ensures strict confidentiality of personal client information and data.
- Drafts and edits documents/communications, as needed.
- Assists clinical staff in providing excellent customer service to all clients.
- Any other duties as required by supervisor.

**What you'll need**:

- 3+ years of billing and collections experience.
- 2+ years of billing and collections experience in the healthcare sector preferred.
- Bachelor's degree required.
- Extremely detail-oriented with excellent analytical, problem-solving, and organizational skills.
- Ability to keep confidential medical records of patients.
- Works well in groups as well as individually, with mínimal supervision.
- Flexible, adaptive, punctual, and highly reliable.

**Why Forge?**

**The opportunity**:
Our team refuses to compromise on integrity, and we look for talented, driven hard workers who hold the same passion for the pursuit of high quality, evidence-based mental health and substance use care that we do. Our collective passion is driven and embodied by our core values:

- _Fulfilling: _Our work creates lives that are complete and self-actualized, enabling stronger families and communities - and a therapeutic community rewarded by success
- _Optimistic: _Our passionate positivity and empathy overcome setbacks and get you to your goals, scientifically and humanely
- _Reciprocal: _Without mutual trust and commitment, there can be no progress
- _Grateful: _We profoundly recognize and appreciate the trust of our patients and the commitment of our clinicians
- _Evidence-Based: _We are committed to measurable outcomes, which provide confidence to our patients and creates a standard of care for ourselves and others

**The package**:
At Forge, our people are our greatest asset. We're collaborative, empathetic, and passionate. We learn from our mistakes, we carve out time to breathe, and we are celebrated for our wins. In short, we know that we can't do what we do without you So, we designed a comprehensive, competitive benefits package that reflects our appreciation of our people:

- Competitive salary aligned with your experience
- Comprehensive paid time off package
- Annual time off to volunteer
- Parental leave
- Annual continuing education al

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